Abstract
After spinal surgery, physiotherapeutic exercises are performed to achieve a rapid return to normal life. One important aim of treatment is to regain muscle strength, but it is known that muscle forces increase the spinal loads to potentially hazardous levels. It has not yet been clarified which exercises cause high spinal forces and thus endanger the surgical outcome. The loads on vertebral body replacements were measured in 5 patients during eleven physiotherapeutic exercises, performed in the supine, prone, or lateral position or on all fours (kneeling on the hands and knees). Low resultant forces on the vertebral body replacement were measured for the following exercises: lifting one straight leg in the supine position, abduction of the leg in the lateral position, outstretching one leg in the all-fours position, and hollowing the back in the all-fours position. From the biomechanical point of view, these exercises can be performed shortly after surgery. Implant forces similar or even greater than those for walking were measured during: lifting both legs, lifting the pelvis in the supine position, outstretching one arm with or without simultaneously outstretching the contralateral leg in the all-fours position, and arching the back in the all-fours position. These exercises should not be performed shortly after spine surgery.
Highlights
Patients with a severe compression fracture of a vertebral body are often surgically treated with an internal spinal fixation device implanted from the posterior and with a vertebral body replacement (VBR) inserted anteriorly
The aim of this paper is to present the loads on a VBR, measured during physiotherapeutic exercises in a lying position and while kneeling on the hands and knees
The resultant forces on a VBR were measured for physiotherapeutic exercises in three different lying positions and the all-fours position
Summary
Patients with a severe compression fracture of a vertebral body are often surgically treated with an internal spinal fixation device implanted from the posterior and with a vertebral body replacement (VBR) inserted anteriorly. Physiotherapeutic exercises are performed to regain muscle strength and to enhance a rapid return to normal life. To improve their strength, the muscles must be activated . A few existing musculoskeletal models [1,2,3,4,5,6,7] are appropriate for calculating the spinal loads during complex activities. Validation of these models for complex activities is difficult due to a lack of experimental data
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