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: 7915744
• 负责人: Howard S An
• 金额: $ 17.41万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7915744
• 关键词: Age; Biological; Biological Preservation; Biomechanics; Cervical; Chronic low back pain; Clinical; Data; Development; Diagnosis; Disease; Elements; Evaluation; Facet joint structure; Goals; Grant; Height; In Vitro; Intervertebral disc structure; 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; Recruitment Activity; Research; Severities; Simulate; Spinal; Spinal Degenerative Disorder; Symptoms; Techniques; Testing; Time; Torsion; Validation; Vertebral column; Visual; Weight; X-Ray Computed Tomography; alternative treatment; analog; analytical method; base; design; in vitro testing; in vivo; intervertebral disk degeneration; kinematics; physical conditioning; pressure; sex; 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.

拟议的研究重点是了解和开发新的方法来诊断腰痛 由节段性不稳定和椎间盘退行性变化引起的问题和/或 面。在正在进行的研究中，我们发现椎间盘的严重程度 退化和扭转和屈伸运动增加。显著差异 在关节突退变和椎间盘退变中， 科目然而，椎间盘退变和小关节之间的机械关系仍然是， 澄清一下。在更新计划项目资助的项目1中，我们将定义运动学超机动性， 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， 症状我们建议进行一项为期五年的研究，研究退行性变化与节段性病变的体内关系。 腰椎不稳在这项拟议的研究中，我们将重新评估，在五年的时间间隔，25 无症状的正常人和25名年龄和性别匹配的有症状的受试者， 在当前的赠款周期中。我们将在本研究中检验的假设是：（1）更大的节段性活动度 和/或特定的运动学模式有助于加速椎间盘和小面退变， （2）通过小关节的载荷传递取决于载荷方向， 椎间盘退变和高度，以及运动节段水平和小面取向。具体 目的是（1）测量与以下各项相关的旋转和屈曲/伸展节段运动的变化： 每名受试者5年内的椎间盘和小关节退行性变（纵向体内研究， 正常受试者和机械性腰痛受试者），和（2）调查，使用尸体腰椎 脊柱，椎间盘退变与高度，节段运动，椎间盘压力和小关节的关系 关节压力，并分析改变的运动学和负荷传递之间的相关性（ 体外实验研究）。预计拟议研究的结果对以下方面同样有效： 诊断颈椎不稳并评估许多新的运动保留治疗方法 正在使用或开发中。