Clinical Biomechanics of the Spine

  • John H. Evans


The spine lends support to the body and forms the fulcrum on which muscles act to cause motion and to resist inertial and external forces. In clinical terms it is most significant that it also provides flexible armor to the spinal cord and cauda equina. Owning in part to its unique, dual roles of support and protection and to the number of pain and other neurological problems arising in the spine, it has received widespread attention from scientists as well as clinicians. In addition to the obvious concern of physicians and surgeons in disorders of the spine, the allied professions also seek a better understanding of the nature of pain-related and otherwise disabling abnormalities. Others with a professional interest in the spine include those seeking a more basic understanding of its structure and function, both normal and abnormal, and of its tolerance to adverse environments and its susceptibility to damage.


Lumbar Spine Motion Segment Interbody Fusion Posterior Lumbar Interbody Fusion Bony Union 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Boshuizen HC, Bongers PM, Hulshof CTJ (1992) Self-reported back pain in forklift truck and freight-container tractor drivers exposed to whole-body vibration. Spine 17 (1): 59–65PubMedCrossRefGoogle Scholar
  2. 2.
    O’Brien JP (1983) The role of fusion for chronic low back pain. Orthop Clin North Am 14 (3): 639PubMedGoogle Scholar
  3. 3.
    Bogduk N, Macintosh JE, Pearcy MJ (to be published) A universal model of the lumbar back muscles in the upright position. SpineGoogle Scholar
  4. 4.
    Bogduk N, Twomey LT (1987) Clinical anatomy of the lumbar spine. Churchill Livingstone, New YorkGoogle Scholar
  5. 5.
    Tesh K, Shaw-Dunn J, Evans JH (1987) The abdominal muscles and spinal stability. Spine 12 (5): 501–508PubMedCrossRefGoogle Scholar
  6. 6.
    Siereg A, Arvikar RJ (1975) A comprehensive musculoskeletal model of the human vertebral column. Advances in Bioengineering. In: Proceedings of the Winter Annual Meeting of Bioengineering Divsion of ASME, Houston, Texas. American Society of Mechanical Engineers, pp 74–75 (Advances in Bioengineering Series)Google Scholar
  7. 7.
    Yettram AL, Jackman MJ (1980) Equilibrium analysis for the forces in the human spinal column and its musculature. Spine 5: 402–411PubMedCrossRefGoogle Scholar
  8. 8.
    Adams MA, Hutton WC, Stott JRR (1980) The resistance to flexion of the lumbar intervertebral joint. Spine 5 (3): 245–253PubMedCrossRefGoogle Scholar
  9. 9.
    Lin HS, Liu YK, Adams KH (1978) Mechanical response of the lumbar intervertebral joint under physiological (complex) loading, J Bone Joint Surg [Am] 60-A(1): 41–55Google Scholar
  10. 10.
    Johnstone B, Urban JPG, Roberts S, Menage J (1992) The fluid content of the intervertebral disc. Spine 17 (4): 412–416PubMedCrossRefGoogle Scholar
  11. 11.
    Crispo JJ, Panjabi MM (1992) Euler stability of the human ligamentous lumbar spine. Part 1: Theory. Clin Biomech 7: 19–26Google Scholar
  12. 12.
    Crispo JJ, Panjabi MM, Yamamoto I, Oxland TR (1992) Euler stability of the human ligamentous lumbar spine. Part 2: Experiment. Clin Biomech 7: 27–32Google Scholar
  13. 13.
    Adams MA, Hutton WC (1983) The mechanical function of the lumbar apophyseal joints. Spine 8 (3): 327–330PubMedCrossRefGoogle Scholar
  14. 14.
    Gracovetsky S, Farfan HF, Lamy C (1981) The mechanisms of the lumbar spine. Spine 6: 249–262PubMedCrossRefGoogle Scholar
  15. 15.
    Holm S, Maroudas A, Urban JPG, Selstam G, Nachemson AL (1981) Nutrition of the intervertebral disc: Solute transport and metabolism. Connect Tissue Res 8: 101–119Google Scholar
  16. 16.
    Holm S, Nachemson AL (1981) Nutritional changes in the canine intervertebral disc after spinal fusion. Clin Orthop 169: 243–258Google Scholar
  17. 17.
    Holm S, Nachemson AL (1983) Variations in the nutrition of the canine intervertebral disc induced by motion. Spine 8: 866–874PubMedCrossRefGoogle Scholar
  18. 18.
    Panagiotacopulos ND, Pope MH, Bloch R, Krag MH (1987) Water content in human intervertebral discs: Part 2. Viscoelastic Behaviour. Spine 12 (9): 918–924PubMedCrossRefGoogle Scholar
  19. 19.
    Urban JPG, Holm S, Maroudas A, Nachemson AL (1982) Nutrition of the intevertebral disc. Effect of fluid flow on solute transport. Clin Orthop 170: 296–302Google Scholar
  20. 20.
    McGill SM, Brown S (1992) Creep response of the lumbar spine to prolonged full flexion. Clin Biomech 7: 43–46CrossRefGoogle Scholar
  21. 21.
    Fast A (1988) Low back disorders: Conservative management. Arch Phys Med Rehab 69: 880–891Google Scholar
  22. 22.
    Macintosh JE, Bogduk N (1991) Attachments of the lumbar erector spinae. Spine 16 (7): 787–792CrossRefGoogle Scholar
  23. 23.
    Macintosh JE, Bodgduk N (1987) The morphology of the lumbar erector spinae. Spine 12: 658–668PubMedCrossRefGoogle Scholar
  24. 24.
    Evans JH (1985) Biomechanics of lumbar fusion. Clin Orthop Rel Res 193: 38–46Google Scholar
  25. 25.
    Chow DHK, Luk KDK, Leong JCY, Evans JH (1992) Segmental mobility of the lumbar spine after fusion — a radiological and a biomechanical study. In: Chan FHY, Chan KL, Mak AFT’, Schindler F (eds) Proceedings of the Biomedical Engineering Symposium. Hong Kong Institution of Engineers, Hong Kong, pp 21–24Google Scholar
  26. 26.
    Farfan HF, Kirkaldy-Willis WH (1981) The present status of spinal fusion in the treatment of lumbar intervertebral joint disorders. Clin Orthop 158: 198PubMedGoogle Scholar
  27. 27.
    Frymoyer JW, Selby DK (1985) Segmental instability: Rationale for treatment. Spine 10: 280–286Google Scholar
  28. 28.
    Pope MH (1987) The biomechanical basis for early care programmes. Ergonomics 30: 351–358PubMedCrossRefGoogle Scholar
  29. 29.
    Thomas I, Evans JH (1988) Acoustic emission from vertebral bodies. J Mat Sci Letters 7: 267CrossRefGoogle Scholar
  30. 30.
    Hansson T, Roos B (1981) The relation between bone mineral content, experimental compression fractures and disc degeneration in lumbar vertebrae. Spine 6: 147PubMedCrossRefGoogle Scholar
  31. 31.
    Hansson T, Roos B (1981) Microcalluses of the trabeculae in lumbar vertebrae and their relation to the bone mineral content. Spine 6: 375PubMedCrossRefGoogle Scholar
  32. 32.
    Bergmark A (1987) Mechanical stability of the human lumbar spine. Doctoral dissertation, Lund Institute of Technology, Department of Solid Mechanics, Lund, SwedenGoogle Scholar
  33. 33.
    Crispo JJ (1989) The biomechanical stability of the human lumbar spine: Experimental and theoretical investigations. Doctoral dissertation, Yale University, New Haven, ConnecticutGoogle Scholar
  34. 34.
    Kirkaldy-Willis WH, Farfan HF (1982) Instability of the lumbar spine. Clin Orthop 165: 110–123PubMedGoogle Scholar
  35. 35.
    Nachemson A (1985) Lumbar spine instability: A critical update and symposium summary. Spine 10: 290–291PubMedCrossRefGoogle Scholar
  36. 36.
    Posner I, White AA, Edwards WT, Hayes WC (1982) A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine 7: 374PubMedCrossRefGoogle Scholar
  37. 37.
    Bohlman HH (1985) Treatment of fractures and dislocations of the thoracic and lumbar spine. Current concept review. J Bone Joint Surg [Am] 67 (1): 165–169Google Scholar
  38. 38.
    Lin PM (1982) Introduction of PLIF, biomechanical principles, and indications. In: Lin PM (ed) Posterior lumbar interbody fusion. Charles C Thomas, Springfield, IL, pp 3–57Google Scholar
  39. 39.
    Selby DK (1983) When to operate and what to operate upon. Orthop Clin N Am 14 (3): 577–587Google Scholar
  40. 40.
    Wetzel FT, La Rocca H (1991) The failed posterior lumbar interbody fusion. Spine 16 (7): 839–845PubMedCrossRefGoogle Scholar
  41. 41.
    Spengler DM, Freeman C, Westbrook R, Miller J (1980) Low back pain following lumbar spine procedures. Failure of initial selection? Spine 5: 356PubMedCrossRefGoogle Scholar
  42. 42.
    Pearcy MJ, Evans JH, O’Brien JP (1983) The load bearing capacity of vertebral cancellous bone in interbody fusion of the lumbar spine. Eng Med 183–184Google Scholar

Copyright information

© Springer-Verlag Tokyo 1992

Authors and Affiliations

  • John H. Evans
    • 1
  1. 1.Rehabilitation Engineering CentreHong Kong PolytechnicHong KongChina

Personalised recommendations