Julius Wolff Institut (JWI) - Center for Musculoskeletal Biomechanics and Regeneration 

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Spine Biomechanics

Chronic low back pain is a significant public health problem in industrialized society. The intact spine carries the upper body and external loads, allows motion in a physiological range and protects the spinal cord. These different demands necessitate a high degree of complexity with various sources for disorders and pain. The JWI conducts research in order to counter pain causes and to further optimize the pain treatment.

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Spinal Load Analyses

We now know that back pain is partly due to an overloading of the spine, particularly due to specific activities in competitive sports or even when lifting heavy loads at work. However, a complete direct measurement of spinal loading is not possible until now. Indirect measurements give information such as the change in height after the change of body position, the intra-abdominal pressure, the intradiscal pressure, electromyographic signals from muscles and the loading of implants to stabilize the spine. Because measuring methods have proven to be extremely difficult, we also use mathematical models. After appropriate validity check this can provide information on forces acting in different spinal regions and adjacent muscles.

Invers Dynamic Models

Inverse dynamic models were used to conclude from observed motions to forces and moments acting in the spine and at surrounding structures. These loads allow evaluation of the stress conditions in joints, joint cartilage, bone, muscles, tendons, and ligaments. Analyses can be performed for any static and dynamic load scenario during physical training or in daily routine.

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Finite Element Models

Finite element models used for the mechanical analysis of biological structures have the advantage of being bloodless and not being dependent on preparations. Their results are reproducible and parameter variations can be performed by keeping all but one parameter constant. Here different finite element models are described that were developed in our laboratory. Although the main interest is in the lumbar region, the thoracic and sacral parts being adjacent to the lumbar one cannot be neglected when dealing with questions related to pelvis and spine altogether.

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Instrumented Vertebral Body Replacements

Severe compression fractures of a vertebral body or a tumour in the region of the spine sometimes require the replacement of a vertebral body by an implant. The loads on such an implant are not well known. In order to measure these loads, the commercially available vertebral body replacement "SYNEX" was modified. It allows the in vivo measurement of three force components and three moments acting on the implant. The 9-channel telemetry transmitter developed in our biomechanics laboratory was placed into the cylinder of the implant together with six load sensors and a coil for the inductive power supply.

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Instrumented Spinal Fixation Devices

Unstable spines are often stabilized using an internal spinal fixation device. If, for example, a vertebra is fractured, screws are fixed posteriorly to the adjacent vertebrae left and right from the spinous process. On both sides a longitudinal rod is fixed to the screws. The spinal load is then partly shared by the paired implanted fixators. In a second operation a cage or/an iliac crest bone graft is inserted into the fractured region from anterior. Usually, the bone graft will fuse with the adjacent vertebrae within a year and form a stable block.

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