PubMed Health⌕ Search

Biomedical subjects

M Panjabi

Publications and source records attributed to M Panjabi.

At least 19 recordsLinked to original sources

Effect of elongation rate on the failure properties of the rabbit anterior cruciate ligament.

The effect of elongation rate on the failure properties of the rabbit femur-anterior crucicate ligament-tibia were investigated. Paired limbs were elongated to failure at rates of 0.0001 m s(-1) and 0.92 m s(-1). Two distinct types of tibial avulsion injury reflecting rate-dependent areas of weakness were noted. 'Bony avulsions' formed by the junction between cortical and trabecular bone comprised the predominant injury observed at the faster elongation rate. 'Fibrous avulsions' between the zones of mineralized fibrocartilage and bone occurred predominantly at the slower elongation rate. The faster rate significantly increased ultimate load (74%) and stiffness (615%) on average, relative to the slow rate. In contrast to what has been previously described, there was a significant decrease in failure deformation (79%) at the faster rate.

Journal Article↗

[The unstable spine--an "in vitro" and "in vivo study" on better understanding of clinical instability].

In cases of suspected painful instability of a cervical segment, temporary external fixation by means of external fixator was applied. The segmental immobilization caused immediate relief of pain. The pain reoccurred after removal of the immobilization. The effect of immobilization by external fixation was investigated in biomechanical tests using fresh cadaveric C4-7 specimens. Multidirectional flexibility was measured before and after application of the fixator at C4/C5, C5/C6 and C4-6. We measured the reduction in motion between the different segments. In every situation the neutral zone decreased more than the range of motion. The findings are helpful to understand the clinical instability of the spine and support the hypothesis that the neutral zone is more closely associated with clinical instability than range of motion. The combination of clinical application and biomechanical investigation allowed us to establish a direct correlation between instability and pain.

Accidents, Traffic↗

An analysis of errors in kinematic parameters associated with in vivo functional radiographs.

A pair of functional radiographs, taken at each end of the range of motion, are used to determine spinal motions. Graphic construction and computer-assisted methods are available for the radiographic analysis. The later provides many more motion parameters. A study of lumbar spine lateral radiographs was conducted to determine errors in the motion parameters due to spinal level, radiographic quality, and errors in the two digitizing instruments. Significant differences were found in the errors due to the two digitizers when the same radiographic pair was redigitized several times. There were only minimal differences, however, between the digitizers when the radiographic films were remarked and redigitized. The error ranges (2 x SD) for the motion parameters were 1) rotation = +/- 1.25 degrees; 2) translation of the inferior posterior vertebral body corner = +/- 0.86 degrees; and 3) coordinates for the center of rotation = +/- 4.3 mm. Both the spinal level and radiographic quality affected the magnitude of errors in all motion parameters.

Computer Graphics↗

Age and gender related normal motion of the cervical spine.

The purpose of this study was to develop a clinical method for measuring three-dimensional motion of the cervical spine using the CA 6000 Spine Motion Analyzer (Orthopaedic Systems Inc., Hayward CA). Normal values for passive examinations of flexion-extension, lateral bending, rotation, rotation out of maximum flexion, and rotation out of maximum extension were obtained and analyzed for each gender in a group of 150 normal subjects. Gender classifications were further subdivided into age groups, with each decade containing asymptomatic volunteers. Values for each group were compared for differences with respect to age and gender differences. A detailed error analysis was also performed on the interobserver and intraobserver repeatability, differences between passive and active testing, and the use of different fixation devices. Significantly decreased motion differences were found between age groups within gender, and between gender groups in corresponding decades. Results of rotation out of maximum flexion suggest and support earlier conclusions that the rotation of the C1-C2 segment does not decrease with age, but rather increases slightly to perhaps compensate for the overall decreased motion in the lower segments.

Adult↗

Effects of alar ligament transection on upper cervical spine rotation.

Fresh human cadaveric specimens of occiput (C0) to C3 were subjected to axial torque. The resulting physiological motions were studied in an unconstrained three-dimensional manner. Effects of sequential transections of the left and right alar ligaments on the relative motions of C0-C1 and C1-C2 were studied. After transection of the left alar ligament, ranges of motion--due to 1.5 Nm torque--increased at both the C0-C1 and C1-C2 joints. Increases were small, on average 1.9 degrees to each side and at each level. Increases due to subsequent cutting of the right alar ligament were, on average, only 0.5 degrees and statistically not significant. In general, neutral zones showed greater increases, e.g., 3.9 degrees to each side at the C1-C2 joint. Comparing right and left axial rotations, after transection of the left alar ligament, showed greater percentage increases for the right, as compared to the left, axial rotation, at both C0-C1 and C1-C2 joints. Functional loss of the alar ligaments indicates a potential for rotatory instability, which, however, must be determined in conjunction with other clinical findings, such as neurological dysfunction, pain, and deformity.

Adult↗

Flexion, extension, and lateral bending of the upper cervical spine in response to alar ligament transections.

The purpose of this in vitro experimental study was to determine the role of alar ligaments in providing flexion, extension, and lateral bending stability to the upper cervical spine. Ten fresh human cadaver specimens occiput-C3 were studied in a complete unconstrained and three-dimensional manner, first intact and then after sequential cutting of the left and right alar ligaments. At the C0-C1 joint, there were increases in flexion motion with sequential cutting of the alar ligaments but none in extension. For the same joint, cutting of the left alar ligament resulted in a significant increase in neutral zone in right lateral bending but not in left lateral bending, whereas there were no significant increases in the ranges of motion. At the C1-C2 joint, there were significant increases both in flexion and extension due to cutting of the left alar ligament, but subsequent cutting of the right alar ligament resulted in a small increase for flexion only. At this joint, right lateral bending increased due to cutting of the left alar ligament, but the same was not true for the left lateral bending. Subsequent cutting of the right alar ligament resulted in significant increases for both the right and left lateral bending.

Adult↗

Posterior occipitocervical fusion. A preliminary report of a new technique.

A new technique for occipitocervical fusion is described. The fixation of the upper cervical spine with plates and screws avoids the possible disadvantages of the commonly used wiring technique. By the establishment of a rigid fixation between the occiput and upper cervical spine with a combination of plates and screws, especially with transarticular atlantoaxial screw fixation, reliable, multidirectional, and immediate stability is achieved. The clinical picture and analysis of 14 patients with a variety of pathologies of the upper cervical spine is presented. The satisfactory outcome and solid bony fusion in all 14 patients and the absence of severe complications encourages the continued use of this technique of occipitocervical fusion.

Arthritis, Rheumatoid↗

Spinal stability and intersegmental muscle forces. A biomechanical model.

The human spinal column, devoid of musculature, is incapable of carrying normal physiologic loads. In an in vitro experiment, the effect of simulated intersegmental muscle forces on spinal instability was investigated. Intact and sequentially injured fresh lumbar functional spinal units were subjected to three-dimensional biomechanical tests with increasing muscle forces. With the application of muscle forces, range of motion (ROM) increased and neutral zone (NZ) decreased in flexion loading, while both ROM and NZ decreased in extension loading. In lateral bending, ROM and NZ were unaffected by the application of the muscle forces. In axial rotation, ROM decreased significantly, while NZ decrease was statistically insignificant. It was concluded that the action of the intersegmental muscle forces is to maintain or decrease intervertebral motions after injury, with the exception of the flexion ROM, which increased with the application of muscle forces. In addition, the study suggested that Neutral Zone is a better indicator of spinal instability than Range of Motion.

Biomechanical Phenomena↗

How does posture affect coupling in the lumbar spine?

There is evidence to suggest that abnormal coupling patterns in the lumbar spine may be an indicator of low-back problems. To quantify the normal coupling patterns, fresh cadaveric human lumbar spine specimens (L1-S1) were used. A pure axial torque or lateral bending moment of 10 N-m (in five equal steps) was applied to the specimen, in five spinal postures, and three-dimensional motions were measured at the five vertebral levels. The results indicated that the coupling patterns changed significantly with the intervertebral level. For example, in neutral posture, the left axial torque produced coupled lateral bending, which varied from approximately 2 degrees right lateral bending at L1-2, to approximately 0 degrees at L3-4, and to approximately 2.5 degrees left lateral bending at L5-S1. Additionally, there was coupled flexion of approximately 1 degrees to 2 degrees at all levels. Application of left lateral bending moment resulted in approximately 1.7 degrees of coupled right axial rotation at all levels, except at L1-L2, where it was 0 degrees. Additionally, there was coupled flexion of 0.7 degrees to 2 degrees at all levels. For example, at the L2-3 level, the left axial torque produced coupled right lateral bending that ranged from approximately 0.5 degrees at full extension to approximately 2.5 degrees at full flexion. There was also accompanying coupled flexion of approximately 0.4 degrees to 1.7 degrees. Application of left lateral bending moment at the L2-3 level produced axial rotation of approximately 2.5 degrees, which did not vary with the posture, while the other coupled motion varied from approximately 1.7 degrees flexion at full extension posture to approximately 0.8 degrees extension at full flexion posture.

Biomechanical Phenomena↗

Three-dimensional movements of the upper cervical spine.

Knowledge of the normal movements of the occipito-atlanto-axial joint complex is important for evaluating clinical cases that may be potentially unstable. The purpose of this in vitro study was to quantitatively determine three dimensional movements of the occiput-C1 and C1-C2 joints. Ten fresh cadaveric whole cervical spine specimens (occiput to C7) were studied, using well-established techniques to document the movements in flexion, extension, left and right lateral bending, and left and right axial rotation. Pure moments of a maximum of 1.5 N-m were applied incrementally, and three-dimensional movements of the bones were recorded using stereophotogrammetry. Each moment was applied individually and in three load/unload cycles. The motion measurements were made on the third load cycle. Parameters of neutral zone, elastic zone, and range of motion were computed. Neutral zones for flexion/extension, right/left lateral bending, and right/left axial rotation were, respectively: 1.1, 1.5, and 1.6 (occiput-C1); and 3.2, 1.2, and 29.6 degrees (C1-C2). Ranges of motion for flexion, extension, lateral bending (one side), and axial rotation (one side) were, respectively: 3.5, 21.0, 5.5, and 7.2 degrees (occiput-C1 joint) and 11.5, 10.9, 6.7, and 38.9 degrees (C1-C2 joint). The greatest intervertebral motion in the spine was axial rotation at the C1-C2 joint, with the neutral zone constituting 75% of this motion.

Adult↗

Intrinsic disc pressure as a measure of integrity of the lumbar spine.

Intradiscal pressure and volume measurements were made in 84 fresh cadaveric lumbar spine disc spaces. The nucleus was injected with a roentgenographic contrast agent under fluoroscopic examination. The intrinsic pressure, the pressure at which the agent entered the disc, and the maximum pressure that the disc could hold were measured. The discs were graded for degeneration. The intrinsic and maximum pressures were found to be inversely related to disc degeneration grade, and directly related to each other. Relatively greater degeneration was found at lower levels of the lumbar spine as compared to the upper levels. The intrinsic disc pressure may prove to be a useful clinical tool in the evaluation of spinal integrity.

Biomechanical Phenomena↗

Dynamic compression plate fixation: a biomechanical comparison of unicortical vs bicortical distal screw fixation.

The use of unicortical screws instead of bicortical screws in the extreme outer holes of dynamic compression plates (DCPs) has been recommended to minimize the stress riser effect at the end of the plates. The authors examined in vitro two groups of paired canine femurs after compression plates had been applied to the anterolateral diaphyseal surface bilaterally. Group I: intact paired femurs with bicortical peripheral screws in one DCP and unicortical peripheral screws in the other; Group II: osteotomized paired femurs again comparing unicortical and bicortical peripheral DCP screws. All specimens were torsion tested to failure and the torque, stiffness, energy, rotation, and failure fracture length were calculated. Unicortical screws did not enhance the torsional strength in either group, and significantly compromised stiffness, energy, and rotation in the osteotomized group. The only apparent benefit of unicortical peripheral screws in a DCP was a shorter, less comminuted fracture upon failure.

Animals↗

CT-functional diagnostics of the rotatory instability of upper cervical spine. 1. An experimental study on cadavers.

Twelve specimens of the upper cervical spine were functionally examined by using radiography, cineradiography and computerized tomographic (CT) scan. The range of rotation was measured from CT images after maximal rotations to both sides. The left alar ligament was then cut and the examination repeated. The alar and transverse ligaments could be differentiated on CT images in axial, sagittal, and coronal views. Rotation at occiput-atlas was 4.35 degrees to the right and 5.9 degrees to the left and at atlas-axis it was 31.4 degrees to the right and 33 degrees to the left. After one-sided lesion of the alar ligament, there was an overall increase of 10.8 degrees or 30% of original rotation to the opposite side, divided about equally between the occiput-atlas and the atlas-axis. It is concluded that a lesion (irreversible overstretching or rupture of alar ligaments) can result in rotatory hypermobility or instability of the upper cervical spine.

Axis, Cervical Vertebra↗

Effects of bone graft and electrical stimulation on the strength of healing bony defects in dogs.

Autogenous cancellous bone graft alone or in combination with electrical stimulation is commonly employed yet there exists no conclusive data that the strength of the healing defect is actually modified. The authors examined three groups of paired canine femurs that were torsion tested to failure. Group I (in vitro): an intact femur was compared to a standard defect; Group II (in vivo): a defect alone was compared to a defect plus graft killed at eight weeks; Group III (in vivo): a defect plus graft was compared to a defect graft plus Osteostim (BGS Medical Corp., Milwaukee, Wisconsin) implantable stimulator killed at eight weeks. In Group I the defect decreased the average strength 45% (p = 0.005); in Group II the grafted defect decreased the strength 20% (p = 0.121); in Group III the defect graft plus electrical stimulation increased strength 4% (p = 0.669). At eight weeks, bone grafting, alone or with electrical stimulation did not statistically increase the torsional strength of the healing bony defect.

Animals↗

Biomechanical definitions of spinal instability.

Instability is a mechanical entity, and an unstable structure is one that is not in a optimal state of equilibrium. In the spine, stability is affected by restraining structures that, if damaged or lax, will lend to altered equilibrium and thus instability. Instability is defined as loss of stiffness.

Biomechanical Phenomena↗