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: 7486862
• 负责人: Howard S An
• 金额: $ 15.57万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7486862
• 关键词: Age; Biological; Biological Preservation; Biomechanics; Cervical; Chronic low back pain; Clinical; Condition; Data; Development; Diagnosis; Disease; Elements; Evaluation; Facet joint structure; Goals; Grant; Height; In Vitro; Intervertebral disc structure; Invasive; Lateral; Low Back Pain; Magnetic Resonance Imaging; Measurement; Measures; Mechanical Low Back Pain; Methods; Modeling; Motion; Movement; Outcome; Pain; Pattern; Positioning Attribute; Prognostic Factor; Program Research Project Grants; Range; Recruitment Activity; Research; Severities; Simulate; Spinal; Spinal Degenerative Disorder; Symptoms; Techniques; Testing; Time; Torsion; Validation; Vertebral column; Visual Analogue Pain Scale; Weight; X-Ray Computed Tomography; analytical method; base; design; in vivo; intervertebral disk degeneration; kinematics; pressure; sex; size; transmission process; virtual

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.

建议的研究重点是了解和开发诊断下腰痛的新方法。 节段不稳和椎间盘和/或退行性改变引起的问题 小平面。在正在进行的研究中，我们发现，椎间盘的严重程度与 扭转和屈伸运动的退变和增加。显著差异是 在无症状和有症状之间的小关节退变和椎间盘退变中发现 研究对象。然而，椎间盘退变和小关节之间的机制关系仍然是 被澄清了。在更新计划项目拨款的项目1中，我们将在 并将这些测量与下腰痛症状相关联。我们 将确定对椎间盘和小关节退行性变进展具有重要预后意义的因素 症状。我们建议进行一项为期五年的体内退行性改变与节段性改变关系的研究。 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 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被调查 在当前的赠款周期中。我们将在这项研究中检验的假设是：(1)更大的节段流动性 和/或特定的运动学模式导致加速的椎间盘和小关节退变 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、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/伸节段运动的变化 每个受试者5年内的椎间盘和小关节退变(一项纵向活体研究比较 正常受试者和机械性下腰痛受试者)，和(2)调查，使用身体腰椎 脊柱、椎间盘退变与高度、节段运动、椎间盘压力和小关节之间的关系 关节压力，并分析改变的运动学和载荷传递之间的相关性(和 体外实验研究)。预计拟议研究的结果将对 颈椎不稳的诊断及多种新的活动度保持治疗方案的评价 正在使用或正在开发中。