Viscoelastic Finite-Element Analysis of a Lumbar Motion Segment in Combined Compression and Sagittal Flexion

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Abstract
Study Design. A study using a validated viscoelastic finite-element model of a L2–L3 motion segment to identify the load sharing among the passive elements at different loading rates. Objective. To enhance understanding concerning the role of the loading rate (i.e., speed of lifting and lowering during manual material handling tasks) on the load sharing and safety margin of spinal structures. Summary of Background Data. Industrial epidemiologic studies have shown that jobs requiring a higher speed of trunk motion contribute to a higher risk of industrial low back disorders. Consideration of the dynamic loading characteristics, such as lifting at different speeds, requires modeling of the viscoelastic behavior of passive tissues. Detailed systematic analysis of loading rate effects has been lacking in the literature. Methods. Complex flexion movement was simulated by applying compression and shear loads at the top of the upper vertebra while its sagittal flexion angle was prescribed without constraining any translations. The lower vertebra was fixed at the bottom. The load reached its maximum values of 2000 N compression and 200 N anterior shear while L2 was flexed to 10° of flexion in the three different durations of 0.3, 1, and 3 seconds to represent fast, medium, and slow movements, respectively. The resisted bending moment, gross load-displacement response of the motion segment, forces in facet joints and ligaments, stresses and strains in anulus fibrosus, and intradiscal pressure were compared across different rates. Results. The distribution of stress and strain was markedly affected by the loading rate. The higher loading rate increased the peak intradiscal pressure (12.4%), bending moment (20.7%), total ligament forces (11.4%), posterior longitudinal ligament stress (15.7%), and anulus fiber stress at the posterolateral innermost region (17.9%), despite the 15.4% reduction in their strain. Conclusions. Consideration of the time-dependent material properties of passive elements is essential to improving understanding of motion segment responsesto dynamic loading conditions. Higher loading rate markedly reduces the safety margin of passive spinal elements. When the dynamic tolerance limits of tissues are available, the results provide bases for the guidelines of safe dynamic activities in clinics or industry.