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Spine biomechanics

机译：脊柱生物力学

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Current trends in spine research are reviewed in order to suggest future opportunities for biomechanics. Recent studies show that psychosocial factors influence back pain behaviour but are not important causes of pain itself. Severe back pain most often arises from intervertebral discs, apophyseal joints and sacroiliac joints, and physical disruption of these structures is strongly but variably linked to pain. Typical forms of structural disruption can be reproduced by severe mechanical loading in-vitro, with genetic and age-related weakening sometimes leading to injury under moderate loading. Biomechanics can be used to quantify spinal loading and movements, to analyse load distributions and injury mechanisms, and to develop therapeutic interventions. The authors suggest that techniques for quantifying spinal loading should be capable of measurement "in the field" so that they can be used in epidemiological surveys and ergonomic interventions. Great accuracy is not required for this task, because injury risk depends on tissue weakness as much as peak loading. Biomechanical tissue testing and finite-element modelling should complement each other, with experiments establishing proof of concept, and models supplying detail and optimising designs. Suggested priority areas for future research include: understanding interactions between intervertebral discs and adjacent vertebrae; developing prosthetic and tissue-engineered discs; and quantifying spinal function during rehabilitation. "Mechanobiology" has perhaps the greatest future potential, because spinal degeneration and heating are both mediated by the activity of cells which are acutely sensitive to their local mechanical environment. Precise characterisation and manipulation of this environment will be a major challenge for spine biomechanics. (c) 2005 Elsevier Ltd. All rights reserved.
机译：回顾了脊柱研究的当前趋势，以提出生物力学的未来机会。最近的研究表明，心理社会因素影响背痛行为，但并不是造成疼痛本身的重要原因。严重的背痛通常是由椎间盘，骨po关节和sa关节引起的，这些结构的物理破坏与疼痛密切相关，但变化无常。结构破坏的典型形式可以通过严重的体外机械负荷来复制，遗传和与年龄相关的减弱有时会导致中等负荷下的损伤。生物力学可用于量化脊柱负荷和运动，分析负荷分布和损伤机制，以及开发治疗性干预措施。作者建议，量化脊柱负荷的技术应能够在“现场”进行测量，以便可以将其用于流行病学调查和人体工程学干预措施。这项任务不需要很高的准确性，因为受伤的风险取决于组织的脆弱性以及最大的负荷量。生物力学组织测试和有限元建模应相互补充，实验应建立概念验证，模型应提供详细信息并优化设计。建议的未来研究重点领域包括：了解椎间盘与相邻椎骨之间的相互作用;开发假体和组织工程性椎间盘;并量化康复过程中的脊柱功能。 “机械生物学”可能具有最大的未来潜力，因为脊柱变性和发热均由对其局部机械环境极为敏感的细胞活性介导。这种环境的精确表征和操纵将是脊柱生物力学的主要挑战。 （c）2005 Elsevier Ltd.保留所有权利。

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