title: Stability provided by the sternum and rib cage in the thoracic spine.
abstract: METHODS
  Multidirectional flexibility tests were conducted on 10 human thoracic spines with intact rib cage.
  
  
  OBJECTIVE
  To determine the amount of stability the rib cage imparts to the thoracic spine and to show the amount of stability lost by a sternal fracture.
  
  
  BACKGROUND
  There is no published study of biomechanical testing of human cadaveric specimens with the rib cage intact.
  
  
  METHODS
  In this study, 10 human cadaveric thoracic spines with the rib cage intact were tested using a biaxial material testing machine and an opto-electronic three-dimensional motion measuring device (Opto-trak 3020). The specimens were tested in axial compression, axial rotation, lateral bending, and flexion/extension. First, the specimens were tested through all four loading types with the sternum and rib cage intact. Next, the sternum was fractured at the sternomanubrial junction displacing the proximal fragment posteriorly. Lastly, the entire rib cage was removed.
  
  
  RESULTS
  The rib cage increased the stability of the thoracic spine by 40% in flexion/extension (P = 0.012), 35% in lateral bending (P = 0.008), and 31% in axial rotation (P = 0.008). An indirect flexion-compression type of sternal fracture decreased the stability of the thoracic spine by 42% in flexion/extension (P = 0.036), 22% in lateral bending (P = 0.038), and 15% in axial rotation (P = 0.011).
  
  
  CONCLUSIONS
  The rib cage significantly increases the stability of the thoracic spine in flexion/extension, lateral bending, and axial rotation. A sternal fracture significantly decreases the stability of the thorax.
authors.affiliation: Los Angeles Spine Surgery Institute, California 90057, USA. Roberto_watkins@yahoo.com
authors.forename: Robert
authors.initials: R
authors.lastname: Watkins
authors.forename: Robert
authors.initials: R
authors.lastname: Watkins
authors.forename: Lytton
authors.initials: L
authors.lastname: Williams
authors.forename: Scott
authors.initials: S
authors.lastname: Ahlbrand
authors.forename: Ryan
authors.initials: R
authors.lastname: Garcia
authors.forename: Ara
authors.initials: A
authors.lastname: Karamanian
authors.forename: Lorra
authors.initials: L
authors.lastname: Sharp
authors.forename: Chuong
authors.initials: C
authors.lastname: Vo
authors.forename: Thomas
authors.initials: T
authors.lastname: Hedman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena / Q000379:methods; D005260:Female; D050723:Fractures, Bone / Q000503:physiopathology; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018583:Pliability; D004856:Postural Balance / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology; D012272:Ribs / Q000502:physiology*; D013249:Sternum / Q000293:injuries / Q000502:physiology*; D013904:Thoracic Vertebrae / Q000502:physiology*