Neutral zone and range of motion in the spine are greater with stepwise loading than with a continuous loading protocol. An in vitro porcine investigation.

Biomechanical testing of the spine has traditionally been performed to help understand the normal function of the spine as well as to evaluate the effects of injury and surgical procedures on spinal behaviour. The overall objective of this investigation was to compare traditional stepwise loading with the recently introduced continuous loading protocol, determining the effect of loading protocol on the mechanical behaviour of the spine. For all tests, a custom spine testing machine was used to apply pure moments of flexion extension, axial rotation, and lateral bending to a maximum of 2 Nm, using six porcine cervical spine specimens (C2-C4). Motions of C2 with respect to C4 were measured with an optoelectronic camera system. Motion parameters calculated were range of motion (ROM), neutral zone (NZ), and the ratio of NZ and ROM. The continuous loading protocol had smaller values for all motion parameters in each loading direction (p<0.05). ROM for the continuous test ranged between 88% and 93% of that of stepwise for the three loading directions. The continuous protocol NZ was 56-75% of that of the stepwise test. The findings of the study demonstrate that the two loading protocols provide differing spinal behaviours.