굽힘하중에 대한 퇴행성 추간판의 생체역학적 특성 분석

Biomechanical Behaviors of Disc Degeneration on Bending Loads

Aging has been recognized as the primary cause of disc degeneration. A biomechanical characteristics of disc degeneration has been demonstrated that intradiscal pressure is reduced. With the increasing population of elderly people, disc degeneration and associated problems of nerve entrapment are becoming more prevalent. Presently, research on reduced intradiscal pressure associated with degeneration is insufficient. In this study. we used the Finite Element Method (FEM) of computerized simulations to investigate the effects of variation in intradiscal pressure on mechanical behaviours of L4-5 intervertebral disc degeneration. Degeneration was classified using four grades based on initial intradiscal pressure; Normal (135 kPa), mild(107 kPa), moderate (47 kPa) and severe (15 kPa). The predicted results f3r bending loads were as follows; 1 . Range of motion increased progressively with severity of degeneration with flexion and lateral bending moments, but decreased with extension moments. 2. Discal bulging of posterolateral aspect was larger in lateral bending and extension moment. But bulging was increased with severity of degeneration in lateral bending and torsion(same side).3. The rate of increasing intradiscal pressure was decreased in all bending motions with severity of degeneration. In conclusion, lateral bending and extension moment yield greatest bulging in severe degeneration. In torsion, although bending load produces disc bulging, disc bulging was associated more strongly with severity of degeneration than increasing torsional moments. Clinical Implications: Discal bulging may produce nerve root impingement and irritation. The effect of loading and posture on the varying degrees of disc degeneration has important implications especially in the elderly. In the presence of disc degeneration, avoidance of end range postures, especially extension and lateral bending may help reduce discal bulging and in turn, nerve entrapment.