Torsion-induced pressure distribution changes in human intervertebral discs: an in vitro study.
METHODS
Biomechanical testing of human cadaveric lumbar specimens was performed to evaluate the effects of torsional torque on intradiscal pressure and disc height.


OBJECTIVE
Evaluate the effects of small torsion torques on intradiscal pressure and disc height in human lumbar specimens.


BACKGROUND
Nuclear depressurization in addition to an instantaneous disc height increase were found in previous porcine research when small (<2 degrees) axial vertebral rotations were applied. If applicable to human spines, this phenomenon may support spinal manipulation for the relief of low back pain.


METHODS
Six human lumbar cadaveric functional spine units (FSU) were loaded in the neutral position with 600 N axial compression. Intranuclear pressure measurements were then obtained at 0, 0.5, 1.0, and 2.0 Nm of torsion. Posterior elements were removed and measurements were repeated for the disc body unit (DBU).


RESULTS
There was no statistically significant difference in nuclear pressure or intervertebral disc height with different torsion torques among or between the FSUs and DBUs. However, a disc height increase ranging from 0.13 mm to 0.16 mm occurred with the insertion of a 1.85-mm diameter pressure probe cannula.


CONCLUSIONS
Small torsion torques showed no significant difference in intradiscal pressures or disc heights. This is an unlikely mechanism for the perceived benefits of spinal manipulation.
Yantzer
Brenda K
BK
Department of Neurological Surgery and Rehabilitation, University of South Florida, Tampa, FL, USA.
Freeman
Thomas B
TB
Lee
William E
WE
Nichols
Tann
T
Inamasu
Joji
J
Guiot
Bernard
B
Johnson
Wesley M
WM
D019245:Compressive Strength; D006801:Humans; D066298:In Vitro Techniques; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000502:physiology*; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy; D008159:Lumbar Vertebrae; D026201:Musculoskeletal Manipulations; D011312:Pressure; D014102:Torsion Abnormality; D016474:Weight-Bearing