Diurnal changes in spinal mechanics and their clinical significance

Adams, M. A.<sup>1</sup>; Dolan, P.<sup>1</sup>; Hutton, W. C.<sup>2</sup>; Porter, R. W.<sup>3</sup>

Affiliations

¹Comparative Orthopaedic Research Unit, University of Bristol, Park Row, Bristol BS1 SLS, England

²Department of Orthopaedics, Emory University, Atlanta, Georgia, USA

³Doncaster Royal Infirmary, Armthorpe Road, Doncaster, South Yorkshire DN2 5LT, England

Abstract

Diurnal changes in the loads acting on the spine affect the water content and height of the intervertebral discs. We have reviewed the effects of these changes on spinal mechanics, and their possible clinical significance.

Cadaveric lumbar spines subjected to periods of creep loading show a disc height change similar to the physiological change. As a result intervertebral discs bulge more, become stiffer in compression and more flexible in bending. Disc tissue becomes more elastic as its water content falls, and its affinity for water increases. Disc prolapse becomes more difficult. The neural arch and associated ligaments resist an increasing proportion of the compressive and bending stresses acting on the spine. Observations on living people show that these changes are not fully compensated for by modified muscle activity.

We conclude that different spinal structures are more heavily loaded at different times of the day. Therefore, the time of onset of symptoms and signs, and any diurnal variation in their severity, may help us understand more about the pathophysiology of low back pain and sciatica.

Links

DOI: 10.1302/0301-620X.72B2.2138156

PubMed: 2138156

WoS: A1990CV55400019

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Cited By (28)

Year	Entry
2003	Urban JPG, Roberts S. Degeneration of the intervertebral disc. Arthritis Res Ther. 2003;5(3):120-130.
1991	Adams MA, Dolan P. A technique for quantifying the bending moment acting on the lumbar spine in vivo. J Biomech. 1991;24(2):117-126.
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2001	Dhillon N, Bass EC, Lotz JC. Effect of frozen storage on the creep behavior of human intervertebral discs. Spine. April 15, 2001;26(8):883-888.
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2016	Balkovec C. Intervertebral Disc Height Loss and Restoration: Outcomes and Implications [PhD thesis]. University of Waterloo; 2016.
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2018	Gruevski KM. The Aging Spine: The Effect of Cyclic Loading, Simulated Degeneration and Prolonged Sitting on Joint Stiffness Across Age [PhD thesis]. University of Waterloo; 2018.