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首页> 外文期刊>Spine >Muscle activation strategies and symmetry of spinal loading in the lumbar spine with scoliosis.
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Muscle activation strategies and symmetry of spinal loading in the lumbar spine with scoliosis.

机译：脊柱侧弯的腰椎脊柱肌肉负荷激活策略和对称性。

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STUDY DESIGN: Biomechanical analysis of muscle and spinal forces in a lumbar spine with scoliosis. OBJECTIVES: To calculate spinal loading asymmetry and its dependence on muscle activation strategy. SUMMARY OF BACKGROUND DATA: It is commonly assumed that a spine with scoliosis experiences greater loading on the concave side and that this asymmetric loading causes asymmetric growth and progression of deformity. However, neither the magnitude of the asymmetric loading imposed on the spine as a function of the scoliosis curve nor the resulting mechanically altered vertebral growth and disc remodeling have been quantified. METHODS: Spinal loading was estimated in a lumbar spine model with increasing degrees of scoliosis. External loading was each of three pure moments or forces acting at T12, with magnitudes of either 50% or 75% of maximum effort. For each external loading, the muscle activation patterns were determined with each of three different muscle activation strategies in an optimization model: 1) minimize the sum of cubed muscle stresses; 2) minimize spinal asymmetric load (i.e., "follower load"); and 3) reverse the spinal load asymmetry (increased compression on convex side) at the level of the apex. RESULTS: The first strategy produced loading that tended to increase the curve magnitude, with the resultant force acting at up to 15 mm lateral to the intervertebral disc center. Both Strategies 2 and 3 had increased muscle stress averaging between 42% and 75%. CONCLUSIONS: We speculate that individuals with scoliosis can adopt different muscle activation strategies and that these strategies may determine whether or not the spinal loading causes scoliosis progression during growth. Muscle activation patterns generating spinal loading that does not promote curve progression during growth have greater physiologic cost.
机译：研究设计：脊柱侧弯腰椎肌肉和脊柱力量的生物力学分析。目的：计算脊柱负荷不对称及其对肌肉激活策略的依赖性。背景数据概述：通常假定脊柱侧弯的脊柱在凹侧承受更大的载荷，并且这种不对称载荷导致不对称生长和畸形发展。但是，既没有对作为脊柱侧弯曲线函数的脊柱施加不对称载荷的大小，也没有对由此产生的机械改变的椎骨生长和椎间盘重塑进行量化。方法：在脊柱侧弯程度增加的腰椎模型中估计脊柱负荷。外部载荷是在T12上作用的三个纯力矩或力中的每一个，其大小为最大作用力的50％或75％。对于每个外部负载，在优化模型中分别使用三种不同的肌肉激活策略来确定肌肉激活模式：1）最小化立方体肌肉压力之和; 2）尽量减少脊柱不对称载荷（即“跟随者载荷”）; 3）扭转脊椎负荷的不对称性（凸侧的压缩增加）。结果：第一种策略产生的载荷趋向于增加弯曲幅度，并且合力作用在距椎间盘中心横向15 mm处。策略2和策略3均增加了平均42％至75％的肌肉压力。结论：我们推测脊柱侧弯的个体可以采用不同的肌肉激活策略，并且这些策略可以确定脊柱负荷在生长过程中是否导致脊柱侧弯的进展。产生脊柱负荷的肌肉激活模式在生长过程中不促进曲线的进展，具有更大的生理成本。

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