Clinical Biomechanics of the Spine (2nd Edition) by Augustus A. White

By Augustus A. White

Covers scoliosis & the constrained position of bracing, spinal trauma, together with burst fractures, & the function of activities & athetics in cervical backbone accidents.

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Detailed physical properties of this ligament are given in Table 1-3. " This allows a large amount of exten­ sion of the ligament without permanent (residual) deformation. Clinically, this is an important charac­ teristic. [n a situation when the spine suddenly goes from full flexion (ligament stretched) to full exten­ sion ( l igament relaxed), the high elasticity of the yellow l igament, together with its pre-tension, mini­ mizes the chances of any impingement of the spinal cord. ''' The tension was measured by inserting pins under local anesthesia into the supraspinous and interspinous ligaments between L3 and L4, from the posterior direction, in the sagit­ tal plane.

Slresses in the Disc Stress at a point in a tissue is defined as the force per unit area. When the stresses at a point exceed the strength of the tissue at that point, the tissue fails. Therefore, in order to understand the failure mecha­ nisms of the disc, it is necessary to know the orienta­ tion and magnitude of the stresses generated in re­ sponse to the various loads applied to the disc. The stresses may be tensile/compressive and/or shear. The first two are called normal stresses and are per­ pendicular to the plane of observation, while the shear stresses are parallel to the plane.

About 20' of rotation was generally required to produce the fail­ ure. The angle of failure was somewhat less for de­ generated discs. Sharp, cracking sounds emanating from the specimen were always noted before failure occurred. On close examination. no failure of the end-plates was found. It is bel ieved that the cracking sounds came from the injuries to the annulus. This is reminiscent of the crack or snap that is sometimes felt or heard when patients report acute low back injuries. Farfan and col leagues·· tested a total of 21 non­ degenerated and 1 4 degenerated discs from the lum­ bar region according to the technique described above.

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