MRI evaluation of spontaneous intervertebral disc degeneration in the alpaca cervical spine.

Animal models have historically provided an appropriate benchmark for understanding human pathology, treatment, and healing, but few animals are known to naturally develop intervertebral disc degeneration. The study of degenerative disc disease and its treatment would greatly benefit from a more comprehensive, and comparable animal model. Alpacas have recently been presented as a potential large animal model of intervertebral disc degeneration due to similarities in spinal posture, disc size, biomechanical flexibility, and natural disc pathology. This research further investigated alpacas by determining the prevalence of intervertebral disc degeneration among an aging alpaca population. Twenty healthy female alpacas comprised two age subgroups (5 young: 2-6 years; and 15 older: 10+ years) and were rated according to the Pfirrmann-grade for degeneration of the cervical intervertebral discs. Incidence rates of degeneration showed strong correlations with age and spinal level: younger alpacas were nearly immune to developing disc degeneration, and in older animals, disc degeneration had an increased incidence rate and severity at lower cervical levels. Advanced disc degeneration was present in at least one of the cervical intervertebral discs of 47% of the older alpacas, and it was most common at the two lowest cervical intervertebral discs. The prevalence of intervertebral disc degeneration encourages further investigation and application of the lower cervical spine of alpacas and similar camelids as a large animal model of intervertebral disc degeneration.

Biomechanical analysis of the camelid cervical intervertebral disc.

Chronic low back pain (LBP) is a prevalent global problem, which is often correlated with degenerative disc disease. The development and use of good, relevant animal models of the spine may improve treatment options for this condition. While no animal model is capable of reproducing the exact biology, anatomy, and biomechanics of the human spine, the quality of a particular animal model increases with the number of shared characteristics that are relevant to the human condition. The purpose of this study was to investigate the camelid (specifically, alpaca and llama) cervical spine as a model of the human lumbar spine. Cervical spines were obtained from four alpacas and four llamas and individual segments were used for segmental flexibility/biomechanics and/or morphology/anatomy studies. Qualitative and quantitative data were compared for the alpaca and llama cervical spines, and human lumbar specimens in addition to other published large animal data. Results indicate that a camelid cervical intervertebral disc (IVD) closely approximates the human lumbar disc with regard to size, spinal posture, and biomechanical flexibility. Specifically, compared with the human lumbar disc, the alpaca and llama cervical disc size are approximately 62%, 83%, and 75% with regard to area, depth, and width, respectively, and the disc flexibility is approximately 133%, 173%, and 254%, with regard to range of motion (ROM) in axial-rotation, flexion-extension, and lateral-bending, respectively. These results, combined with the clinical report of disc degeneration in the llama lower cervical spine, suggest that the camelid cervical spine is potentially well suited for use as an animal model in biomechanical studies of the human lumbar spine.

A standardized representation of spinal quality of motion.

The experimentally determined torque-rotation curve of the lumbar spine is mathematically described with a proposed dual-inflection point Boltzmann equation. The result is a method for describing functional spinal unit motion data. The benefit of the model is that each of the coefficients has a specific meaning in relation to the torque-rotation curve: the points A and B identify the respective minimum and maximum rotations of the functional spinal unit, m1 and m2 indicate the inflection points of the curve where the stiffness changes markedly, and α1 and α2 are associated with the rates of change of the curve at m1 and m2, respectively. The dual-inflection point Boltzmann captures the full quality of motion of the spinal segment and can also be used to derive relevant parameters such as range of motion, midrange stiffness, and hysteresis.

Characterization and prediction of rate-dependent flexibility in lumbar spine biomechanics at room and body temperature.

BACKGROUND CONTEXT: The soft tissues of the spine exhibit sensitivity to strain-rate and temperature, yet current knowledge of spine biomechanics is derived from cadaveric testing conducted at room temperature at very slow, quasi-static rates. PURPOSE: The primary objective of this study was to characterize the change in segmental flexibility of cadaveric lumbar spine segments with respect to multiple loading rates within the range of physiologic motion by using specimens at body or room temperature. The secondary objective was to develop a predictive model of spine flexibility across the voluntary range of loading rates. STUDY DESIGN: This in vitro study examines rate- and temperature-dependent viscoelasticity of the human lumbar cadaveric spine. METHODS: Repeated flexibility tests were performed on 21 lumbar function spinal units (FSUs) in flexion-extension with the use of 11 distinct voluntary loading rates at body or room temperature. Furthermore, six lumbar FSUs were loaded in axial rotation, flexion-extension, and lateral bending at both body and room temperature via a stepwise, quasi-static loading protocol. All FSUs were also loaded using a control loading test with a continuous-speed loading-rate of 1-deg/sec. The viscoelastic torque-rotation response for each spinal segment was recorded. A predictive model was developed to accurately estimate spine segment flexibility at any voluntary loading rate based on measured flexibility at a single loading rate. RESULTS: Stepwise loading exhibited the greatest segmental range of motion (ROM) in all loading directions. As loading rate increased, segmental ROM decreased, whereas segmental stiffness and hysteresis both increased; however, the neutral zone remained constant. Continuous-speed tests showed that segmental stiffness and hysteresis are dependent variables to ROM at voluntary loading rates in flexion-extension. To predict the torque-rotation response at different loading rates, the model requires knowledge of the segmental flexibility at a single rate and specified temperature, and a scaling parameter. A Bland-Altman analysis showed high coefficients of determination for the predictive model. CONCLUSIONS: The present work demonstrates significant changes in spine segment flexibility as a result of loading rate and testing temperature. Loading rate effects can be accounted for using the predictive model, which accurately estimated ROM, neutral zone, stiffness, and hysteresis within the range of voluntary motion.

Intervertebral disc degeneration alters lumbar spine segmental stiffness in all modes of loading under a compressive follower load.

BACKGROUND CONTEXT: Previous studies have investigated the relationship between the degeneration grade of the intervertebral disc (IVD) and the flexibility of the functional spinal unit (FSU) but were completed at room temperature without the presence of a compressive follower load. This study builds on previous work by performing the testing under more physiological conditions of a compressive follower load at body temperature and at near 100% humidity. PURPOSE: The present work evaluates the effects of IVD degeneration on segmental stiffness, range of motion (ROM), hysteresis area, and normalized hysteresis (hysteresis area/ROM). This study also briefly evaluates the effect of the segment level, temperature, and follower load on the same parameters. STUDY DESIGN: In vitro human cadaveric biomechanical investigation. METHODS: Twenty-one FSUs were tested in the three primary modes of loading at both body temperature and room temperature in a near 100% humidity environment. A compressive follower load of 440 N was applied to simulate the physiological conditions. Fifteen of the 21 segments were also tested without the follower load to determine the effects of the follower load on segmental biomechanics. The grade of degeneration for each segment was determined using the Thompson scale, and the torque-rotation curves were fit with the Dual-Inflection-Point Boltzmann sigmoid curve. RESULTS: Intervertebral disc degeneration resulted in statistically significant changes in segmental stiffness, ROM, and hysteresis area in axial rotation (AR) and lateral bending (LB) and statistically significant changes in ROM and normalized hysteresis in flexion-extension (FE). The progression of these changes with increased degeneration is nonlinear, with changes in the FE and LB tending to respond in concert and opposite to the changes in AR. The lumbosacral joint was significantly stiffer and demonstrated a decreased ROM and hysteresis area as compared with other lumbar segments in AR and LB. Temperature had a significant effect on the stiffness and hysteresis area in AR and on the hysteresis area in LB. Application of a compressive follower load increased the stiffness in all three modes of loading but was significant only in AR and LB. It also reduced the ROM and increased normalized hysteresis in all three modes of loading. CONCLUSIONS: The results from this testing quantify the effects of degeneration on spinal biomechanics. Because the testing was conducted under physiological conditions (including a compressive follower load and at body temperature), we expect the measured response to closely match the in vivo response. The testing results can be used to guide the selection of appropriate surgical treatments in the context of IVD degeneration and to validate the mathematical and engineering models of the lumbar spine, including finite element models.