Comparison of intradiscal pressures and spinal fixator loads for different body positions and exercises

Abstract

Loading of the spine is still not well understood. The most reliable results seemed to come from the intradiscal pressure measurements from studies by Nachemson, 1966. A new similar study by Wilke et al. (1999) complemented the present study and confirmed some of the earlier data, although it contradicted others. The new data did not confirm that the load on the spine is higher in sitting compared with standing and did not find distinct differences between positions in which subjects were lying down. The objective of this paper was to compare results from two independent in vivo studies (applying different methods) to provide information about spinal loading. In one of these studies (Wilke 1999), intradiscal pressure was measured in one volunteer in different postures and exercises, and in the other study (Rohlmann et al. 1994) the loads on an internal spinal fixation device (an implant for stabilising unstable spines) were determined in 10 patients. The absolute values of the results from both studies were normalized and compared for many body positions and dynamic exercises. The relative differences in intradiscal pressure and flexion bending moments in the fixators corresponded in most cases. Both studies showed slightly lower loads for sitting than for standing and comparatively low loads in all lying positions. High loads were measured for jogging, jumping on a trampoline and skipping. Differences between trends for intradiscal pressure and for flexion bending moments in the fixators were found when the load was predominantly carried by the anterior spinal column, as during flexion of the upper part of the body or when lifting and carrying weights. The combination of the results from these two methods may improve the understanding of the biomechanical behaviour of the lumbar spine and may be used to validate models and theories of spinal loading.