Ultimate strength of the lumbar spine in flexion--an in vitro study.

The ultimate strength in flexion of 16 lumbar functional spinal units (FSU) was determined. The specimens were exposed to a combined static load of bending and shearing in the sagittal plane until overt rupture occurred (simulated flexion-distraction injuries). The biomechanical response of the FSU was measured with a force and moment platform. Mechanical displacement gauges were used to measure vertical displacements (flexion angulation) of the specimens. Photographs were taken after each loading step for determination of horizontal displacements and the centre of rotation. The lumbar FSU could resist a combination of bending moment and shear force of 156 Nm and 620 N respectively, before complete disruption occurred. The tension force acting on the posterior structures was 2.8 kN. The flexion angulation just before failure was 20 degrees and the anterior horizontal displacement between the upper and lower vertebrae was 9 mm. The centre of rotation was located in the posterior part of the lower vertebral body. The bone mineral content in the vertebrae appeared to be a good predictor of ultimate strength of the lumbar FSU. Knowledge of the biomechanical response of the lumbar spine under different static traumatic loads is a first step to better understand the injury mechanisms of the spine in traffic accidents.