Clin Orthop Surg.  2017 Dec;9(4):480-488. 10.4055/cios.2017.9.4.480.

Effects of Different Angles of the Traction Table on Lumbar Spine Ligaments: A Finite Element Study

• Farajpour
• Jamshidi N

• KMID: 2412249
• DOI: http://doi.org/10.4055/cios.2017.9.4.480

Abstract

BACKGROUND
The traction bed is a noninvasive device for treating lower back pain caused by herniated intervertebral discs. In this study, we investigated the impact of the traction bed on the lower back as a means of increasing the disc height and creating a gap between facet joints.
METHODS
Computed tomography (CT) images were obtained from a female volunteer and a three-dimensional (3D) model was created using software package MIMICs 17.0. Afterwards, the 3D model was analyzed in an analytical software (Abaqus 6.14). The study was conducted under the following traction loads: 25%, 45%, 55%, and 85% of the whole body weight in different angles.
RESULTS
Results indicated that the loading angle in the L3-4 area had 36.8%, 57.4%, 55.32%, 49.8%, and 52.15% effect on the anterior longitudinal ligament, posterior longitudinal ligament, intertransverse ligament, interspinous ligament, and supraspinous ligament, respectively. The respective values for the L4-5 area were 32.3%, 10.6%, 53.4%, 56.58%, and 57.35%. Also, the body weight had 63.2%, 42.6%, 44.68%, 50.2%, and 47.85% effect on the anterior longitudinal ligament, posterior longitudinal ligament, intertransverse ligament, interspinous ligament, and supraspinous ligament, respectively. The respective values for the L4-5 area were 67.7%, 89.4%, 46.6%, 43.42% and 42.65%. The authenticity of results was checked by comparing with the experimental data.
CONCLUSIONS
The results show that traction beds are highly effective for disc movement and lower back pain relief. Also, an optimal angle for traction can be obtained in a 3D model analysis using CT or magnetic resonance imaging images. The optimal angle would be different for different patients and thus should be determined based on the decreased height of the intervertebral disc, weight and height of patients.

Keyword

Low back pain; Viscoelastic; Prony series; Maxwell model; Ligaments

MeSH Terms

Adult
Biomechanical Phenomena
Body Weight
Computer Simulation
Elasticity
Female
Finite Element Analysis
Humans
Imaging, Three-Dimensional
Intervertebral Disc/*diagnostic imaging/physiology
Longitudinal Ligaments/*diagnostic imaging/physiology
Lumbar Vertebrae/*diagnostic imaging
Patient Positioning
Tomography, X-Ray Computed
*Traction/instrumentation
Viscosity

Figure

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  Fig. 1 Lumbar spine model with ligaments. ALL: anterior longitudinal ligament, PLL: posterior longitudinal ligament, SSL: supraspinous ligament, ISL: interspinous ligament, ITL: intertransverse ligament.

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  Fig. 2 (A) Disc model with two fibrosus parts of nucleus pulposus (NP) and annulus fibrosis (AF). (B) Maxwell model for viscoelastic materials.11)

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  Fig. 3 Load and angle apply method in Taguchi design of experiment.

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  Fig. 4 Relative displacements of intervertebral discs (mm) under 45% of body weight loading.

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  Fig. 5 Relative displacements of intervertebral discs (mm) under 55% of body weight loading.

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  Fig. 6 The results of Taguchi design of experiment on anterior longitudinal ligament in the L3–4 area (A) and L4–5 area (B).

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  Fig. 7 The results of Taguchi design of experiment on posterior longitudinal ligament in the L3–4 area (A) and L4–5 area (B).

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  Fig. 8 The results of Taguchi design of experiment on intertransverse ligament in the L3–4 area (A) and L4–5 area (B).

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  Fig. 9 The results of Taguchi design of experiment on interspinous ligament in the L3–4 area (A) and L4–5 area (B).

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  Fig. 10 The results of Taguchi design of experiment on supraspinous ligament in the L3–4 area (A) and L4–5 area (B).

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  Fig. 11 Comparison between results of this study and a clinical study for 45% of body weight loading.

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  Fig. 12 Comparison between results of this study and a clinical study for 55% of body weight loading.

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