Biomechanical analysis of combining head-down tilt traction with vibration for different grades of degeneration of the lumbar spine.
In recent years, a combination of traction and vibration therapy is usually used to alleviate low back pain (LBP) in clinical settings. Combining head-down tilt (HDT) traction with vibration was demonstrated to be efficacious for LBP patients in our previous study. However, the biomechanics of the lumbar spine during this combined treatment is not well known and need quantitative analysis. In addition, LBP patients have different grades of degeneration of the lumbar spinal structure, which are often age related. Selecting a suitable rehabilitation therapy for different age groups of patients has been challenging. Therefore, a finite element (FE) model of the L1-L5 lumbar spine and a vibration dynamic model are developed in this study in order to investigate the biomechanical effects of the combination of HDT traction and vibration therapy on the age-related degeneration of the lumbar spine. The decrease of intradiscal pressure is more effective when vibration is combined with traction therapy. Moreover, the stresses on the discs are lower in the "traction+vibration" mode than the "traction-only" mode. The stress concentration at the posterior part of nucleus is mitigated after the vibration is combined. The disc deformations especially posterior disc radial retraction is improved in the "traction+vibration" mode. These beneficial effects of this therapy could help decompress the discs and spinal nerves and therefore relieve LBP. Simultaneously, patients with grade 1 degeneration (approximately 41-50 years old) are able to achieve better results compared with other age groups. This study could be used to provide a more effective LBP rehabilitation therapy.
Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China.
Sicong
S
Wang
Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China ; Interdisciplinary Division of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, China. Electronic address: lizhenwang@buaa.edu.cn.
Lizhen
L
Wang
Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China.
Yawei
Y
Wang
Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China.
Chengfei
C
Du
Interdisciplinary Division of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, China.
Ming
M
Zhang
Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China ; National Research Center for Rehabilitation Technical Aids, 100176 Beijing, China. Electronic address: yubofan@buaa.edu.cn.
Yubo
Y
Fan
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D018475:Head-Down Tilt; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000628:therapy*; D017116:Low Back Pain / Q000150:complications / Q000628:therapy; D008159:Lumbar Vertebrae; D008297:Male; D055595:Mechanical Phenomena; D008875:Middle Aged; D014143:Traction / Q000295:instrumentation*; D014732:Vibration
Degeneration; Finite element analysis (FEA); Head-down tilt (HDT) traction; Lumbar spine; Vibration