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.

拟议的研究重点是理解和开发新方法来诊断腰痛 椎间盘的分段不稳定性和退化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 变性和扭转和屈伸运动运动的增加。显着差异 在无症状和有症状之间的方面变性和椎间盘变性中发现 主题。但是，椎间盘变性与方面关节之间的机械关系仍然存在于 被澄清。在续签计划项目赠款的项目1中，我们将定义运动学超重性 体内扭转和屈曲 - 将这些测量与下腰痛症状相关联。我们 将确定对椎间盘和方面联合变性的进展的预后重要性的因素 症状。我们提出了一项为期五年的研究，该研究对退化性变化与分段的体内关系 腰椎不稳定。在这项拟议的研究中，我们将在五年间重新评估25 无症状的正常受试者和25个年龄和性别匹配的症状受试者进行了研究 在当前的赠款周期中。我们将在这项研究中测试的假设是（1）较大的分段迁移率 和/或特定的运动学模式有助于加速椎间盘和方面变性 时间，（2）通过小平台传输负载取决于加载方向和 椎间盘的变性，高度以及运动段水平和方向。具体 目的是（1）测量与 每个受试者五年内的椎间盘和方面变性（体内纵向研究比较 正常受试者和机械腰痛受试者）和（2）使用尸体腰椎调查 刺，椎间盘变性和高度之间的关系，分段运动，圆盘压力和方面 关节压力，并分析改变运动学和负载传播之间的相关性（A 实验性体外研究）。预计拟议研究的结果对 诊断宫颈脊柱不稳定性并评估许多新运动保存治疗替代方案 在使用或开发中。