Spinal Degenerative Disease by Maurice

By Maurice

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Before t h i s h a p p e n e d t h e d i s c v o l u m e fell b y 1—2*5 m l , p r o b a b l y f r o m o b l i t e r a t i o n o f t h e f i s s u r e s w i t h i n it a n d f r o m l o s s o f fluid across t h e cartilage end p l a t e s i n t o t h e v e r t e b r a l b o d i e s . T h e y s p e c u l a t e d as t o w h e t h e r t h e failure of t h e e n d plates c o u l d a c c o u n t for s o m e cases of l o w b a c k p a i n d e v e l o p i n g after physical exertion. I n a f e w s p e c i m e n s t h e y were able to produce annular failure, b u t o n l y b y rapid r e p e a t e d b e n d i n g m o v e m e n t s c o m b i n e d with a m o d e r a t e degree of axial c o m p r e s s i o n .

T h i s r e s u l t s from changes in t h e angle b e t w e e n t h e fibre sheets w h i c h are able t o slide over each other confirmed to by some extent [221]. an X-ray This crystallographic mechanism has recently technique using the been polarizing m i c r o s c o p e [ 2 2 1 ] . P r e v i o u s l y it h a d b e e n t h o u g h t t h a t t h e a n n u l u s w a s a b l e t o dissipate vertical force acting o n t h e n u c l e u s in a h o r i z o n t a l direction merely b y elastic distension o u t w a r d s .

J. Bone Joint Surg. ) T h e a c t u a l p r e s s u r e s p r e s e n t w i t h i n t h e d i s c s u b s t a n c e in vivo measured inserted by Nachemson and Morris[337] needles with pressure-sensitive have been and Nachemson[336]. tips into the third and They fourth l u m b a r discs. In n o n - l o a d - b e a r i n g subjects t h e pressures w e r e highest in t h e 2 s i t t i n g p o s i t i o n , a b o u t 1 0 — 1 5 k g / c m . T h e s e p r e s s u r e s w e r e 3 0 % l e s s if t h e p e r s o n w a s s t a n d i n g , 5 0 % less if h e w a s l y i n g d o w n (Fig.

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