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2024, Vol. 28 ›› Issue (33): 5249-5256

Effect of total ligament superimposed injury on biomechanical characteristics of the lumbar spine

Wang Duoduo1, Lyu Jie1, Guo Panjing1, Ding Lijun2, Cao Jinfeng3, Zhou Nan4, Lyu Qiang4   

  1. 1College of Rehabilitation Sciences, 2School of Medical Instruments, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China; 3Periodicals Agency of Shanghai University, Shanghai 200444, China; 4Department of Massage, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China

  • Received:2023-08-10 Accepted:2023-10-12 Online:2024-11-28 Published:2024-01-30

  • Contact: Lyu Jie, MD, Associate professor, Master’s supervisor, College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China

  • About author:Wang Duoduo, Master candidate, College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China

  • Supported by:

    National Natural Science Foundation of China (General Program), No. 82074571 (to ZN); Shanghai Style Traditional Chinese Medicine School Inheritance and Innovation Team Construction Project, No. 2021LPTD-007 (to LJ)


Abstract: BACKGROUND: Ligaments are an important structure for stabilizing the lumbar spine, and they are prone to degenerative changes with age. Currently, there is limited research on lumbar ligaments.
OBJECTIVE: To investigate the effect of different combinations of ligament injuries on biomechanical characteristics of lumbar spine under four motion states of forward bending, backward extension, lateral bending, and torsion under a certain sequence of ligament injuries.
METHODS: A finite element model of the L4-L5 segment of the lumbar spine was established, and corresponding moments were applied to simulate four motion states of forward bending, backward extension, lateral bending, and torsion. The combined injuries of the ligaments were performed in order to obtain the motion range of each vertebra and the stress of each ligament.
RESULTS AND CONCLUSION: (1) Every time a ligament was removed, the remaining ligament stress would increase. Under all four working conditions, capsular ligament would experience the highest stress, especially during forward bending. With the removal of ligaments, the range of motion of the vertebrae was also continuously increasing. (2) When flexing forward, after removing the first ligament capsular ligament, the average stress change in the remaining ligament was the highest, followed by the removal of supraspinous ligament. After removing capsular ligament, the change rate of range of motion was the highest, while after removing posterior longitudinal ligament, the change rate of range of motion was the lowest. (3) When extending backward, all ligaments had the highest rate of stress change after removing capsular ligament, the highest rate of range of motion change after removing capsular ligament, and the lowest rate of range of motion change after removing posterior longitudinal ligament. (4) When bending, the stress change rate of interspinous ligament decreased after removing intertransverse ligament, while supraspinous ligament increased more. After removing capsular ligament and interspinous ligament, the range of motion change rate increased significantly. (5) During lateral bending, after removing capsular ligament, the stress change rate of the remaining ligament was much higher than that of other ligament damage combinations, and the   range of motion change rate was the highest after removing capsular ligament. In other cases, the range of motion change rate did not exceed 8%. (6) If the root ligament is damaged, the remaining ligaments will undergo stress compensation. Ligament damage will affect the stability of the lumbar spine, with minimal impact in cases of lateral curvature. Patients with lumbar instability should avoid forward flexion and backward extension movements, which can make it easier to detect the pathological condition of the ligaments. (7) Capsular ligament is an important structure for maintaining lumbar stability, and supraspinous ligament plays a significant role in anterior flexion, maintaining the integrity of the entire lumbar ligament.

Key words: finite element analysis, lumbar ligament, ligament injury, capsular ligament, biomechanics


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