Is it possible to estimate the compressive force in the lumbar spine from intradiscal pressure measurements? A finite element evaluation

Knowledge about in vivo spinal compressive forces is a basic requirement for spinal biomechanics. Their direct measurement is not yet possible. Therefore, compressive forces are estimated from in vivo measured intradiscal pressure values. However, it is still not evident how precise these estimations are. A finite element model of the spine was employed to simulate elementary body positions and the compressive force at level L4-5 was calculated. This value was compared with different estimations calculated by multiplying the intradiscal pressure with the disc's cross-sectional area and with a correction factor. A model specific and different previously employed correction factors were used. Separately, in vivo forces were estimated from previously measured pressure values. A model specific correction factor leads for all body positions to a good estimation (error <4%) of the force except for extension (error >27%). Non-model specific correction factors lead to estimation errors of up to 44%. When accounting for these limitations, in vivo forces were estimated e.g. for standing between 430 N and 600 N. Compressive forces can be estimated for non-extended body positions when the individual correction factor is known. In vivo forces can be estimated from intradiscal pressure values within a certain range.