Compressive force magnitude and intervertebral joint flexion/extension angle influence shear failure force magnitude in the porcine cervical spine

Abstract 

Despite the findings that peak anterior shear load is highly correlated with low-back pain reporting, very little research has been conducted to determine how vertebral shear injury potential is influenced. The current study quantified the combined effects of vertebral joint compression and flexion/extension postural deviation from neutral on ultimate shear failure. Ninety-six porcine cervical specimens (48C3–C4, 48C5–C6) were tested. Each specimen was randomly assigned to one of twelve combinations of compressive force (15%, 30%, 45%, or 60% of predicted compressive failure force) and flexion/extension postural deviation (extended, neutral, or flexed). Vertebral joint shear failure was induced by applying posterior shear displacement of the caudal vertebra at a constant rate of 0.15mm/s. Throughout shear failure tests, vertebral joint kinematics were measured using an optoelectronic camera and a series of infrared light emitting diodes while shear force was measured from load cells rigidly interfaced in series with linear actuators that applied the shear displacement. Measurements of shear stiffness, ultimate force, displacement, and energy stored were made from the force–displacement data. Compressive force and postural deviation demonstrated main effects without a statistically significant interaction for any of the measurements. Shear failure force increased by 11.1% for each 15% increment in compressive force (p<0.05). Postural deviation from neutral impacted ultimate shear failure force by a 12.8% increase with extension (p<0.05) and a 13.2% decrease with flexion (p<0.05). Displacement at ultimate failure was not significantly altered by either compressive force or postural deviation. These results demonstrate that shear failure force may be governed by changes in facet articulation, either by postural deviation or by reducing vertebral joint height through compression that alter the moment arm length between the center of facet contact pressure and the pars interarticularis location. However, objective evidence of this alteration currently does not exist. Both compression and flexion/extension postural deviation should be equally considered while assessing shear injury potential.

Keywords: Vertebra, Facet articulation, Injury threshold, Pars interarticularis