Table 4.
Issues and future research directions for human facet joint biomechanics
| Topic Area | Issues | Areas of Needed Research | Potential Future Implications |
|---|---|---|---|
| Tissues | |||
| Facet Cartilage | • Small/thin structure | • Clearer definition of anatomy and geometry of these tissues | • Define healthy and unhealthy |
| Meniscoids | • High spatial variability | • Coupling of tissue biomechanics with physiologic function | • Better understanding of mechanical role of these tissues in biomechanical and physiologic functions of facet joint |
| • Difficult to image | • Comparative analysis relative to other diarthrodial joints | • Define material properties of these tissues for more accurate modeling | |
| • Difficult to access physically without damaging the joint | • Noninvasive technologies for measuring relevant kinematics & kinetics | • Context to integrate with findings from other joints | |
| • Loading depends on other tissues in the joint | • Understanding of mechanotransduction processes | ||
| • Little known about mechanical properties; assumed to be similar to other diarthrodial joints | |||
| Mechanotransduction | |||
| Normal Facet | • Despite extensive work in other joints, mechanisms not defined for facet | • Clearer definition of physiologic cascades of injury, degeneration, aging and pain | • Develop better preventive strategies |
| Developing Facet | • Effects of cyclic loading not defined | • Better understanding of relationships between global & local milieus | • Design treatments to address spinal health problems |
| Aging Facet | • Cellular responses in tissues remote to those under load | • Clearer understanding of local effects of specific tissue interventions for global spine performance | |
| Pain Signaling | • Impact of biomechanics on physiology | • Expanded utility of computational & animal models | |
| • Impact of physiology on biomechanics | |||
| Model Systems | |||
| Computational | • Despite tremendous advances, integration of material and biologic properties of facet tissues remain limited | • More sophisticated models to incorporate degenerative processes, pathologies and dysfunctions | • More realistic models |
| Animal | • Context for human relevance | • Ethical and useful human studies | • Inform about pain/dysfunction |
| Human | • Relevant input parameters | • Appropriate contextualization | • Leverage in vivo imaging to study biomechanics of mechanotransduction |
| • Understanding mutual influence of facet joint and its surrounding structures | |||
| • Investigate effects of current and future surgical interventions | |||