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Caractérisation du comportement mécanique du disque intervertébral intact et fissuré

Abstract : Spinal disorders are the leading cause of disability worldwide. Their burden onto healthcare and social system is enormous in the western countries and it is probably neglect in developing nations. Although define as a non-specific affection, it is sometimes possible to identify patho-anatomical sources leading to the patient pain. Among them, we can find the radial fissure of the annulus fibrosus. This structural lesion triggers a cascade of biological and mechanical events which could lead to the defervescence of the disc. In this thesis, we look closer to the bigger strain /displacement of the nucleus pulposus making possible by the breach of the annulus. McKenzie hypothesize a mobile nucleus into the fissure. These strains / displacements depend on the force imposed onto the spinal functional unit by the physiological movement of the spine. Thus, a flexion strains / displaces the nucleus backward, an extension frontward and so on. To test the relevance of this hypothesis, we used a fourfold approach, including:- A systematic review of the literature with a meta-analysis.- An ex vivo approach, combining quantitative MRI and photomechanical analysis.- An in vivo approach of quantified movement analysis.- An in silico approach of finite elements modelization.Our result, despite being provisory, seems to confirm this hypothesis. But, we are far from a firm and definitive validation. Other researches are needed to finalize these goals.
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https://theses.hal.science/tel-03787920
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Submitted on : Monday, September 26, 2022 - 9:56:02 AM
Last modification on : Friday, October 21, 2022 - 3:45:32 AM

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  • HAL Id : tel-03787920, version 1

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Jean-Philippe Deneuville. Caractérisation du comportement mécanique du disque intervertébral intact et fissuré. Biomécanique [physics.med-ph]. Université de Poitiers, 2021. Français. ⟨NNT : 2021POIT2303⟩. ⟨tel-03787920⟩

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