A method for inducing and determining biomechanics associated with endplate fractures in the lumbar spine.

ABSTRACT

Lumbar spine endplate fracture is not easily detectible using medical imaging, but can lead to pain symptoms. Understanding endplate fracture mechanics can lead to more informed clinical diagnosis and more appropriate safety enhancements for civilian and military vehicles. Lumbar motion segments obtained from PMHS were prepared using two methods. Group 1 (n=6) was potted preserving the natural segmental lordosis while Group 2 (n=4) removed the curvature. Specimens were compressed at 0.5 mm/sec until fracture, observed via real-time fluoroscopy video as radio-opaque dye transferred from the intervertebral disc nucleus into the vertebral body. Fracture was confirmed using CT and dissection. Force, bony acoustics and disc pressure were correlates of fracture. Fractures in Group 1 (5 of 6 specimens) were concentrated in the posterior cortex of the inferior vertebral body whereas Group 2 experienced endplate fractures. The mean sagittal plane angle between endplates for specimens with cortical fracture was 5.1±1.2 degrees, compared to 1.0±0.5 degrees for endplate fracture. The average peak force for cortical fracture was 10.0±1.9 kN and 4.5±0.8 kN for endplate fracture. Pre-positioning during compressive loading has a significant role in determining whether a motion segment sustains a cortical or endplate fracture. Likewise, an appropriately oriented segment can sustain endplate fracture at approximately 45% of the load for cortex fracture.