Contact pressure in the facet joint during sagittal bending of the cadaveric cervical spine

Jaumard, Nicolas V.<sup>1</sup>; Bauman, Joel A.<sup>1</sup>; Weisshaar, Christine L.<sup>1,2</sup>; Guarino, Benjamin B.<sup>2</sup>; Welch, William C.<sup>1</sup>; Winkelstein, Beth A.<sup>1,2</sup>

Affiliations

¹Dept. of Neurosurgery, University of Pennsylvania, HUP - 3 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104

²Dept. of Bioengineering, University of Pennsylvania, 210 S. 33rd Street, Room 240 Skirkanich Hall, Philadelphia, PA 19104

Abstract

The facet joint contributes to the normal biomechanical function of the spine by transmitting loads and limiting motions via articular contact. However, little is known about the contact pressure response for this joint. Such information can provide a quantitative measure of the facet joint's local environment. The objective of this study was to measure facet pressure during physiologic bending in the cervical spine, using a joint capsule-sparing technique. Flexion and extension bending moments were applied to six human cadaveric cervical spines. Global motions (C2-T1) were defined using infra-red cameras to track markers on each vertebra. Contact pressure in the C5-C6 facet was also measured using a tip-mounted pressure transducer inserted into the joint space through a hole in the postero-inferior region of the C5 lateral mass. Facet contact pressure increased by 67.6 ± 26.9 kPa under a 2.4 Nm extension moment and decreased by 10.3 ± 9.7 kPa under a 2.7 Nm flexion moment. The mean rotation of the overall cervical specimen motion segments was 9.6 ± 0.8° and was 1.6 ± 0.7° for the C5-C6 joint, respectively, for extension. The change in pressure during extension was linearly related to both the change in moment (51.4 ± 42.6 kPa/Nm) and the change in C5-C6 angle (18.0 ± 108.9 kPa/deg). Contact pressure in the inferior region of the cervical facet joint increases during extension as the articular surfaces come in contact, and decreases in flexion as the joint opens, similar to reports in the lumbar spine despite the difference in facet orientation in those spinal regions. Joint contact pressure is linearly related to both sagittal moment and spinal rotation. Cartilage degeneration and the presence of meniscoids may account for the variation in the pressure profiles measured during physiologic sagittal bending. This study shows that cervical facet contact pressure can be directly measured with minimal disruption to the joint and is the first to provide local pressure values for the cervical joint in a cadaveric model.

Links

PubMed: 21823743

WoS: 000293524800004

History

Received: 2010-12-22

Revised: 2011-06-02

Online: 2011-06-13

Published: 2011-07-13

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Cited By (5)

Year	Entry
2017	Quarrington R, Costi J, Freeman B, Jones C. Quantitative evaluation of facet deflection, strain and failure load during simulated cervical spine trauma. In: Proceedings of the 13th Ohio State University Injury Biomechanics Symposium. May 21-23, 2017; Columbus, OH.
2011	Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng. July 2011;133(7):071010.
2018	Quarrington RD. Towards Understanding the Injury Mechanics and Clinical Outcomes of Traumatic Subaxial Cervical Facet Dislocation and Fracture-Dislocation [PhD thesis]. University of Adelaide; December 2018.
2013	Mustafy T. Prediction of Load-Sharing Mechanisms and Patterns of Human Cervical Spine Injuries Due to High-Velocity Impact Using Finite Element Method [Master's thesis]. Edmonton, AB: University of Alberta; 2013.
2020	Fabre MAC. Development of Elderly Posture Male and Female Finite Element Neck Models and Assessment of Tissue-Level Response Under Impact Loading [Master's thesis]. University of Waterloo; 2020.