The biomechanics of lumbar disc herniation and the effect of overload and instability.

A multipart study has been performed to provide a mechanical explanation for the epidemiologic association between sitting in static (e.g., factory or office) or vibration (e.g., car or truck driving) environments and acute herniated lumbar discs. It was shown that a 1 h exposure to sitting environments caused significant changes in the mechanical properties of the lumbar intervertebral disc. During many of the latter tests, specimens were unstable (exhibited by a sudden, large flexion and/or lateral bend rotation response to an axially applied load). This showed that a motion segment in the lumbar spine could suddenly buckle and apply a tensile impact loading to the posterolateral region of the disc. We also demonstrated that a combined lateral bend, flexion, and axial rotation vibration loading could cause tracking tears proceeding from the nucleus through the posterolateral region of the anulus. It suggests that a mechanism for disc herniation is mechanical changes leading to instability of the motion segment. These experiments complete the argument that lumbar disc herniations can be a direct mechanical consequence of prolonged sitting in static or vibration environments.