Partitioning of the L4-L5 dynamic moment into disc, ligamentous, and muscular components during lifting.

This work describes a dynamic model of the low back that incorporates extensive anatomical detail of a three-dimensional musculo-ligamentous-skeletal system. The reactive moment about L4-L5, determined from sagittal plane lifts, was partitioned into restorative components provided by the disc in bending, ligament strain, and active muscle contraction. Skeletal kinematics were obtained from cine analysis of markers on the rib cage and pelvis. The musculature was driven from surface EMG collected from six sites. When compared with past models, features of this model included improved anatomical modeling, improved monitoring of vertebral motion unit kinematics, improved estimation of neural activation of the musculature, and consideration of the effects of muscle length, velocity, cross-sectional area and passive elasticity in force estimation. Estimations of L4-L5 disc compression and shear were, on average, 16.2% and 42.5% lower, respectively, than those calculated from a simple 5 cm erector tissue moment arm length. There was no need to invoke intra-abdominal pressure or other contentious compression-reducing mechanisms. Muscle activity, particularly that of the sacrospinalis, dominated the generation of the restorative moment. Ligaments played a very minor role in the lifts studied. High muscle loads are consistent with the common clinical observation of muscle strain often produced by load handling.