Intervertebral Disc Stress and Pressure in Different Daily Postures: A Finite Element Study

Abstract

Low back pain is the most common cause of disability in the United Kingdom with health care costs of more than 1 billion pounds per year. One reason associated with low back pain is the degeneration of intervertebral discs due to loads on the spine. Daily postures such as standing and sitting produce different loads on the discs. Previously, many studies investigated the stress and pressure within the disc in these postures. The results do not agree with each other and the experiments have many limitations. The aim of this project was to assess the feasibility of incorporating magnetic resonance (MR) imaging and finite element (FE) analysis to predict the pressure and stresses developed by different daily postures in an individual. Transient and non-transient subject specific 2D models of nine individuals in standing and sitting were created based on previously acquired MR images. The geometry of these FE models was based on supine MR images. The sitting and standing boundary conditions were calculated by comparing their MR images with the supine posture. The results showed that for six subjects sitting created more intradiscal pressure compared to standing and in one subject standing more than sitting. For two of the subjects the pressure was nearly the same in sitting and standing. Because of the 2D model’s limitations, 3D models of an individual were developed. Both transient and non-transient models of the individual were created. The intradiscal pressure results were three times lower compared to the 2D models. This was due to consideration of out of plane deformation in the 3D models. These results were in the range of in-vivo and in-vitro measurements available in the literature. In conclusion, it was possible to create kinematic transient subject specific FE models based on the MR images in different postures. 2D models provide a method for comparing the postures but 3D models may be more realistic.