Biomechanics of Lumbar Spine Instability

  • Manohar M. Panjabi


Low back pain is the most common and costly disorder of the musculoskeletal system. The magnitude of the problem is well documented by the frequency of its occurrence. In western society, 50%–70% of the population will have low back pain once in their lifetime, and 18% of the population has low back pain at any one time. The cost of this disease for the United States has been estimated at $15–50 billion per year. Although the cause of most low back pain is not known, spinal instability is considered as one of the most important causes [1].


Lumbar Spine Intervertebral Disk Facet Joint Cervical Spine Injury Spinal Stability 
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.


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  1. 1.
    Nachemson A (1985) Lumbar spine instability: A critical update and symposium summary. Spine 10: 290–291PubMedCrossRefGoogle Scholar
  2. 2.
    Knutsson F (1944) The instability associated with disk degeneration in the lumbar spine. Acta Radiologica [Diagn] 25: 593–609CrossRefGoogle Scholar
  3. 3.
    Dvorak J, Panjabi MM, Novotny JE, Chang DG, Grob D (1991) Clinical validation of functional flexion/extension roentgenograms of the lumbar spine. Spine 16 (8): 943–950PubMedCrossRefGoogle Scholar
  4. 4.
    Pearcy M, Portek I, Shepherd J (1985) The effect of low-back pain on lumbar spinal movements measured by three-dimensional X-ray analysis. Spine 10 (2): 150–153PubMedCrossRefGoogle Scholar
  5. 5.
    Nicoll EA (1949) Fractures of the dorsolumbar spine. J Bone Joint Surg [Br] 31: 376–394Google Scholar
  6. 6.
    Holdsworth FW (1962) Fractures, dislocations, and fracture/dislocations of the spine. J Bone Joint Surg [Br] 45: 6–20Google Scholar
  7. 7.
    Louis R (1985) Spinal stability as defined by the three-column spine concept. Anat Clin 7: 33PubMedCrossRefGoogle Scholar
  8. 8.
    Denis F (1983) The three-column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8: 817–831PubMedCrossRefGoogle Scholar
  9. 9.
    Panjabi MM, Goel VK, Takata K (1982) Physiological strains in lumbar spinal ligaments. An in vitro biomechanical study. Spine 7 (3): 192–203PubMedCrossRefGoogle Scholar
  10. 10.
    Oxland TR, Panjabi MM (in press) The onset and progression of spinal injury: A porcine flexion-compression trauma model. J BiomechanicsGoogle Scholar
  11. 11.
    Panjabi MM, Duranceau JS, Oxland TR, Bowen CE (1989) Multidirectional instabilities of traumatic cervical spine injuries in a porcine model. Spine 14 (10): 1111–1115PubMedCrossRefGoogle Scholar
  12. 12.
    Virgin W (1951) Experimental investigations into physical properties of the intervertebral disk. J Bone Joint Surg [Br] 33: 607Google Scholar
  13. 13.
    Farfan HF, Sullivan JD (1967) The relation of facet orientation to intervertebral disk failure. Can J Surg 10: 179PubMedGoogle Scholar
  14. 14.
    Markolf KL, Morris JM (1974) The structural components of the intervertebral disk. J Bone Joint Surg [Am] 56: 675Google Scholar
  15. 15.
    Goel VK, Nishiyama K, Weinstein JN, Liu YK (1986) Mechanical properties of lumbar spinal motion segments as affected by partial disk removal. Spine 11 (10): 1008PubMedCrossRefGoogle Scholar
  16. 16.
    Panjabi MM, Krag MH, Chung TQ (1984) Effects of disk injury on mechanical behavior of the human spine. Spine 9 (7): 707–713PubMedCrossRefGoogle Scholar
  17. 17.
    Mixter WJ, Barr JS (1934) Ruptures of the intervertebral disk with involvement of the spinal canal. N Engl J Med 211: 210CrossRefGoogle Scholar
  18. 18.
    Adams M, Hutton W (1982) 1981 Volvo Award in Basic Science. Prolapsed intervertebral disk: a hyperflexion injury. Spine 7 (3): 184–191Google Scholar
  19. 19.
    Abumi K, Panjabi MM, Duranceau J, Oxland T, Crisco JJ (1990) Biomechanical evaluation of lumbar spinal stability after graded facetectomies. Spine 15 (11): 1142–1147PubMedCrossRefGoogle Scholar
  20. 20.
    Nachemson A (1960) Lumbar interdiskal pressure. Acta Orthop Scand Suppl 43Google Scholar
  21. 21.
    Prasad P, King AI, Ewing CL (1974) The role of articular facets during +Gz acceleration. J Appi Mech 41: 321CrossRefGoogle Scholar
  22. 22.
    White AA, Panjabi MM (1978) Clinical biomechanics of the spine, 1st edn. Lippincott, PhiladelphiaGoogle Scholar
  23. 23.
    Posner I, White A, Edwards T, Hayes W (1982) A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine 7 (4): 374–389PubMedCrossRefGoogle Scholar
  24. 24.
    Crisco JJ, Panjabi MM, Yamamoto I, Oxland TR (in press) Euler stability of the human ligamentous lumbar spine: Part II Experiment. Clin BiomechanicsGoogle Scholar
  25. 25.
    Panjabi MM, Abumi K, Duranceau J, Oxland T (1989) Spinal stability and intersegmental muscle forces: A biomechanical model. Spine 14 (2): 194–200PubMedCrossRefGoogle Scholar
  26. 26.
    Panjabi MM, Pelker R, Crisco J, Thibodeau L, Yamamoto I (1988) Biomechanics of healing of posterior cervical spinal injuries in a canine model. Spine 13 (7): 803–807PubMedCrossRefGoogle Scholar
  27. 27.
    Wetzel FT, Panjabi MM, Pelker RR (1989) Temporal biomechanics of posterior cervical spine injuries in vivo in a rabbit model. J Orthop Res 7: 728–731PubMedCrossRefGoogle Scholar
  28. 28.
    Panjabi MM, White AA, Johnson RM (1975) Cervical spine mechanics as a function of transection of components. J Biomechanics 8: 327–336CrossRefGoogle Scholar
  29. 29.
    Wetzel FT, Panjabi MM, Pelker RR (1989) Biomechanics of the rabbit cervical spine as a function of component transection. J Orthop Res 7: 723–727PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1993

Authors and Affiliations

  • Manohar M. Panjabi
    • 1
  1. 1.Department of Orthopaedics and RehabilitationYale University School of MedicineNew HavenUSA

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