Subject-specific biomechanics of trunk: musculoskeletal scaling, internal loads and intradiscal pressure estimation

Development of a subject-specific computational musculoskeletal trunk model (accounting for age, sex, body weight and body height), estimation of muscle forces and internal loads as well as subsequent validation by comparison with measured intradiscal pressure in various lifting tasks are novel, important and challenging. The objective of the present study is twofold. First, it aims to update and personalize the passive and active structures in an existing musculoskeletal kinematics-driven finite element model. The scaling scheme used an existing imaging database and biomechanical principles to adjust muscle geometries/cross-sectional-areas and passive joint geometry/properties in accordance with subjects' sex, age, body weight and body height. Second, using predictions of a detailed passive finite element model of the ligamentous lumbar spine, a novel nonlinear regression equation was proposed that relates the intradiscal pressure (IDP) at the L4-L5 disc to its compression force and intersegmental flexion rotation. Predicted IDPs and muscle activities of the personalized models under various tasks are found in good-to-excellent agreement with reported measurements. Results indicate the importance of personal parameters when computing muscle forces and spinal loads especially at larger trunk flexion angles as minor changes in individual parameters yielded up to 30% differences in spinal forces. For more accurate subject-specific estimation of spinal loads and muscle activities, such a comprehensive trunk model should be used that accounts for subject's personalized features on active musculature and passive spinal structure.