Critical load of the human cervical spine: an in vitro experimental study

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Panjabi, Manohar M.¹; Cholewicki, Jacek¹; Nibu, Kimio²; Grauer, Jonathan¹; Babat, Lawrence B.¹; Dvorak, Jiri³

Critical load of the human cervical spine: an in vitro experimental study

Clin Biomech (Bristol, Avon). January 1998;13(1):11-17

Affiliations

¹Biomechanics Laboratory, Department of Orthopaedics and Rehabilitation Yale University School of Medicine, New Haven, CT, USA

²Department of Orthopaedics, Yamaguchi University School of Medicine, Yamaguchi, Japan

³Schulthess Klinik, Zurich, Switzerland
Abstract and keywords

Objective: To determine the critical load of the osteoligamentous cervical spine in frontal plane.

Design: Whole human cervical spine specimens were loaded in axial compression with increasing force until the point of buckling.

Background: The osteoligamentous cervical spine and the surrounding muscles support the weight of the head and the external loads applied to it. Critical load is the maximum compressive force that the spinal column can sustain before buckling. Critical loads have been obtained for the osteoligamentous thoracolumbar spine (without the rib cage) and the lumbar spine. Critical load of the cervical spine has not yet been determined.

Methods: When a compressive force is applied to the cervical spine, it bends in the sagittal plane producing greater lordosis. The determination of critical load in Euler's sense requires blocking of this sagittal plane bending. A special apparatus was developed that constrained such bending in the sagittal plane, but allowed complete freedom of the spine motion in the frontal plane. Experiments were conducted to determine the axial force-lateral bending curves of whole cervical spine specimens. Critical load values were obtained from these curves. As an alternative to this method, bending stiffness in the frontal plane was experimentally determined and the critical load was computed using Euler's theory of columns.

Results: Based upon the study of seven spine specimens (CO-T1), the critical load for the human cervical spine was found to be 10.5 (3.8) N obtained by direct experimentation. The average critical load calculated with the Euler theory using bending stiffness data, was 11.9 (2.0), but there were large individual differences when compared with the experimental results.

Conclusions: The critical load of the osteoligamentous human cervical spine is about one-fifth to one-quarter the weight of the average head.

Keywords: Mechanical stability; cervical spine; critical load; biomechanics
Links

DOI: 10.1016/S0268-0033(97)00057-0

PubMed: 11415766

WoS: 000073319300002
History

Accepted: 1997-08-29

Online: 1998-06-23

Cited Works (5)

Year	Entry
1974	Andriacchi T, Schultz A, Belytschko T, Galante J. A model for studies of mechanical interactions between the human spine and rib cage. J Biomech. November 1974;7(6):497-507.
1990	Winter DA. Biomechanics and Motor Control of Human Movement. 2nd ed. New York, NY: Inc., John Wiley & Sons; 1990.
1992	Crisco JJ, Panjabi MM, Yamamoto I, Oxland TR. Euler stability of the human ligamentous lumbar spine, II: experiment. Clin Biomech (Bristol, Avon). February 1992;7(1):27-32.
1991	Janevic J, Ashton-Miller JA, Schultz AB. Large compressive preloads decrease lumbar motion segment flexibility. J Orthop Res. March 1991;9(2):228-236.
1994	Panjabi MM, Oxland TR, Yamamoto I, Crisco JJ. Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves. J Bone Joint Surg. March 1994;76A(3):413-424.

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2015	Nightingale RW, Myers BS, Yoganandan N. Neck injury biomechanics. In: Yoganandan N, Nahum AM, Melvin JW, eds. Accidental Injury: Biomechanics and Prevention. 3rd ed. New York: Springer; 2015:259-308.
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