Coppock James A, Danyluk Stephanie T, Englander Zoë A, Spritzer Charles E, Goode Adam P, DeFrate Louis E
Department of Orthopedic Surgery, Duke University School of Medicine, United States; Department of Biomedical Engineering, Duke University, United States.
Department of Orthopedic Surgery, Duke University School of Medicine, United States.
J Biomech. 2021 May 24;121:110392. doi: 10.1016/j.jbiomech.2021.110392. Epub 2021 Mar 20.
High body mass index (BMI) and obesity have been implicated as risk factors for lumbar degenerative disc disease and low back pain. Despite this, there is limited in vivo data to quantify how obesity influences the mechanical function of intervertebral discs (IVD) in response to activities of daily living. Recently, our lab has developed methodologies to non-invasively measure in vivo IVD deformation resulting from activities of daily living using magnetic resonance (MR) imaging and solid modeling techniques. This pilot study expands on these methodologies to assess how BMI influences IVD deformation following treadmill walking in eight asymptomatic individuals. Ordinary least squares regression analyses revealed a statistically significant relationship between BMI and compressive deformation (strain (%)) in the L5-S1 IVD (R = 0.61, p < 0.05). This relationship was weaker in the L3-L4 (R = 0.28, p > 0.05) and L4-L5 IVDs (R = 0.28, p > 0.05). Importantly, no relationship between pre-exercise disc height and BMI was identified (p > 0.05). Therefore, the results of this study suggest that BMI may alter the mechanical response of lumbar spine IVDs, particularly at the L5-S1 level. Furthermore, the observed relationship between increased BMI and IVD compressive deformation, in the absence of a detected relationship between pre-exercise disc height and BMI, suggests that changes in IVD mechanical function may be more sensitive to alterations in disc health than static clinical imaging alone. This finding highlights the importance of quantifying disc mechanical function when examining the relationship between BMI and IVD degeneration.
高体重指数(BMI)和肥胖已被认为是腰椎退行性椎间盘疾病和腰痛的风险因素。尽管如此,关于肥胖如何影响椎间盘(IVD)在日常生活活动中的力学功能的体内数据有限。最近,我们实验室开发了一些方法,使用磁共振(MR)成像和实体建模技术,非侵入性地测量日常生活活动导致的体内IVD变形。这项初步研究扩展了这些方法,以评估BMI如何影响八名无症状个体在跑步机行走后IVD的变形。普通最小二乘法回归分析显示,BMI与L5-S1椎间盘的压缩变形(应变(%))之间存在统计学上的显著关系(R = 0.61,p < 0.05)。这种关系在L3-L4(R = 0.28,p > 0.05)和L4-L5椎间盘(R = 0.28,p > 0.05)中较弱。重要的是,未发现运动前椎间盘高度与BMI之间存在关系(p > 0.05)。因此,本研究结果表明,BMI可能会改变腰椎间盘的力学反应,特别是在L5-S1水平。此外,在未检测到运动前椎间盘高度与BMI之间存在关系的情况下,观察到的BMI增加与IVD压缩变形之间的关系表明,IVD力学功能的变化可能比单纯的静态临床成像对椎间盘健康变化更敏感。这一发现突出了在研究BMI与IVD退变之间的关系时量化椎间盘力学功能的重要性。