Investigation of possible causal relationships between disc and facet joint degeneration using in-vivo, in vitro and finite element analyses

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The degeneration of the intervertebral disc and the facet joints is one major reason for specific low back pain which can be induced, among other factors, by inappropriate mechanical stresses and overloading. It is still a matter of debate which structure is affected first by degenerative processes and whether a correlation exists between both. This knowledge, however, is crucial for the choice of appropriate treatment strategies. It provides basic know-how to optimize the development of spinal implants and helps to take a decision regarding the indication of fusion or motion-preserving implants.The aim of this research project is to clarify the course of degeneration within a functional spinal unit using an in vivo, in vitro and in silico approach. The in vivo animal experiment on sheep will be used to initiate an intervertebral disc and/or facet joint degeneration by performing various surgical procedures. Over a period of one year, the mutual influence of each of the subsequent degenerative changes will be investigated. The following in vitro experiments will be used to detect morphological changes within affected segments and to implement realistic geometry and material parameters into the developed finite element models. The finite element analyzes will offer valuable clues about the course of degenerative processes in humans taking into account individual spine morphologies and try to elucidate alleged mechanical correlations between pathologic changes of the intervertebral disc and the facet joints.