RELATIONSHIP BETWEEN DISC AND FACET DEGENERATION AND IN VIVO LUMBAR KINEMATICS

椎间盘和小关节退变与体内腰椎运动学之间的关系

• 批准号: 7223261
• 负责人: Howard S An
• 金额: $ 16.04万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7223261
• 关键词: backache; biomechanics; intervertebral disk; joints; spine; spine disorder

The proposed study focuses on understanding and developing new methods to diagnose low back pain problems resulting from both segmental instability and degenerative changes in intervertebral discs and/or facets. In the ongoing study, we found that a relationship exists between the severity of intervertebral disc degeneration and increases in torsional and flexion-extension movements. Significant differences were found in facet degeneration and disc degeneration between the asymptomatic and the symptomatic subjects. However, the mechanistic relationship between disc degeneration and the facet joint remains to be clarified. In Project 1 of the renewal Program Project Grant, we will define kinematic hypermobility in torsion and flexion-extension in vivo and correlate those measurements with low back pain symptoms. We will identify factors of prognostic importance to the progression of disc and facet joint degeneration and symptoms. We propose a five-year study of the in vivo relationship of degenerative changes with segmental instability of the lumbar spine. In this proposed study, we will re-evaluate, over a five-year interval, 25 asymptomatic normal subjects and 25 age- and sex-matched symptomatic subjects, who were investigated in the current grant cycle. Hypotheses that we will test in this study are (1) that greater segmental mobility and/or specific kinematic patterns contribute to accelerated intervertebral disc and facet degeneration over time, and (2) that load transmission through the facet joints depends on the loading direction and intervertebral disc degeneration and height, and motion segment level and facet orientation. The specific aims are (1) to measure changes in rotational and flexion/extension segmental movement associated with disc and facet degeneration over five years within each subject (a longitudinal in vivo study comparing normal subjects and mechanical low back pain subjects), and (2) to investigate, using cadaveric lumbar spines, relationships among disc degeneration and height, segmental movement, disc pressure and facet joint pressure, and to analyze correlations between altered kinematics and load transmission (an experimental in vitro study). The outcome from the proposed study is expected to be equally effective for diagnosis of cervical spinal instability and evaluating many of new motion preservation treatment alternatives in use or under development.

拟议的研究重点是了解和开发诊断腰痛的新方法 由节段不稳定和椎间盘退行性变化引起的问题和/或 方面。在正在进行的研究中，我们发现椎间盘的严重程度之间存在关系 退化以及扭转和屈伸运动的增加。显着差异是 发现于无症状和有症状之间的小关节退变和椎间盘退变 科目。然而，椎间盘退变与小关节之间的机制关系仍不清楚。 予以澄清。在更新计划项目拨款的项目 1 中，我们将定义运动学超机动性 体内扭转和屈伸并将这些测量结果与腰痛症状相关联。我们 将确定对椎间盘和小关节退变进展具有重要预后意义的因素 症状。我们提出一项为期五年的研究，研究退行性变化与节段性变化的体内关系 腰椎不稳定。在这项拟议的研究中，我们将在五年内重新评估 25 对无症状正常受试者和 25 名年龄和性别匹配的有症状受试者进行了调查 在当前的拨款周期中。我们将在本研究中测试的假设是（1）更大的部门流动性 和/或特定的运动模式有助于加速椎间盘和小关节退化 时间，以及（2）通过小关节的载荷传递取决于载荷方向和 椎间盘退变和高度，以及运动节段水平和小关节方向。具体的 目标是 (1) 测量与以下相关的旋转和屈曲/伸展节段运动的变化 每个受试者五年内的椎间盘和小关节退变（一项纵向体内研究比较 正常受试者和机械性腰痛受试者），以及（2）使用尸体腰椎进行研究 脊柱、椎间盘退变与高度之间的关系、节段运动、椎间盘压力和小关节 关节压力，并分析改变的运动学和负载传递之间的相关性（ 体外实验研究）。拟议研究的结果预计对以下方面同样有效 颈椎不稳的诊断和评估许多新的运动保留治疗方案 正在使用或正在开发中。