By Augustus A. White
Covers scoliosis & the constrained position of bracing, spinal trauma, together with burst fractures, & the function of activities & athetics in cervical backbone accidents.
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Additional info for Clinical Biomechanics of the Spine (2nd Edition)
About 20' of rotation was generally required to produce the fail ure. The angle of failure was somewhat less for de generated discs. Sharp, cracking sounds emanating from the specimen were always noted before failure occurred. On close examination. no failure of the end-plates was found. It is bel ieved that the cracking sounds came from the injuries to the annulus. This is reminiscent of the crack or snap that is sometimes felt or heard when patients report acute low back injuries. Farfan and col leagues·· tested a total of 21 non degenerated and 1 4 degenerated discs from the lum bar region according to the technique described above.
1 20 However, under the application of 1 2 Nm of torque, the fiber strains were considerably more, about 9%. This probably indicates that the signifi cant compressive loads borne by the spine are car ried not by the outer annular fibers but instead by the nucleus and the inner annular fiber layers. Also, it supports the theory that the annular fibers may be torn by the torsional load and not by the compres sion load. Disc Bulge One of the mechanisms of nerve root irritation is thought to be the root impingement by disc bulge.
We present a highly simplified analysis. To deter mine the mechanism by which the disc is able to carry tensile loads, imagine the disc being cut by a plane that is perpendicular to the fiber directions of an annular lamina. ) To support the tensile loads there are two types of stresses that are produced within the annulus-normal and shear, respectively perpen dicular and parallel to the cut surface. The shear stresses are relatively larger in magnitude. Although the normal stresses are nicely absorbed by the alter nating layers of annular fibers, there is no provision for resisting the shear stresses.
Clinical Biomechanics of the Spine (2nd Edition) by Augustus A. White
Categories: Physical Medicine Rehabilitation