Characterization of the L4-L5-S1 motion segment using the stepwise reduction method

The two aims of this study were to generate data for a more accurate calibration of finite element models including the L5–S1 segment, and to find mechanical differences between the L4–L5 and L5–S1 segments. Then, the range of motion (ROM) and facet forces for the L4–S1 segment were measured using t...

Full description

Autores:: Jaramillo Suárez, Héctor Enrique
Puttlitz, Christian M.
García Álvarez, José Jaime
Mcgilvray, Kirk

Tipo de recurso:: Article of journal

Fecha de publicación:: 2016

Institución:: Universidad Autónoma de Occidente

Repositorio:: RED: Repositorio Educativo Digital UAO

Idioma:: eng

id	REPOUAO2_0162aa63b58864c0f1db9b2547c6b94d
oai_identifier_str	oai:red.uao.edu.co:10614/11047
network_acronym_str	REPOUAO2
network_name_str	RED: Repositorio Educativo Digital UAO
repository_id_str
dc.title.eng.fl_str_mv	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method
title	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method
spellingShingle	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method Biomecánica Movimiento de rotación Mecánica humana Biomechanics Rotational motion Human mechanics L4–L5–S1 segment Stepwise reduction method Range of motion Contact forces
title_short	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method
title_full	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method
title_fullStr	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method
title_full_unstemmed	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method
title_sort	Characterization of the L4-L5-S1 motion segment using the stepwise reduction method
dc.creator.fl_str_mv	Jaramillo Suárez, Héctor Enrique Puttlitz, Christian M. García Álvarez, José Jaime Mcgilvray, Kirk
dc.contributor.author.none.fl_str_mv	Jaramillo Suárez, Héctor Enrique Puttlitz, Christian M. García Álvarez, José Jaime Mcgilvray, Kirk
dc.subject.armarc.spa.fl_str_mv	Biomecánica Movimiento de rotación Mecánica humana
topic	Biomecánica Movimiento de rotación Mecánica humana Biomechanics Rotational motion Human mechanics L4–L5–S1 segment Stepwise reduction method Range of motion Contact forces
dc.subject.armarc.eng.fl_str_mv	Biomechanics Rotational motion Human mechanics
dc.subject.proposal.eng.fl_str_mv	L4–L5–S1 segment Stepwise reduction method Range of motion Contact forces
description	The two aims of this study were to generate data for a more accurate calibration of finite element models including the L5–S1 segment, and to find mechanical differences between the L4–L5 and L5–S1 segments. Then, the range of motion (ROM) and facet forces for the L4–S1 segment were measured using the stepwise reduction method. This consists of sequentially testing and reducing each segment in nine stages by cutting the ligaments, facet capsules, and removing the nucleus. Five L4–S1 human segments (median: 65 years, range: 53–84 years, SD=11.0 years) were loaded under a maximum pure moment of 8 N m. The ROM was measured using stereo-photogrammetry via tracking of three markers and the facet contact forces (CF) were measured using a Tekscan system. The ROM for the L4–L5 segment and all stages showed good agreement with published data. The major differences in ROM between the L4–L5 and L5–S1 segments were found for lateral bending and all stages, for which the L4–L5 ROM was about 1.5–3 times higher than that of the L5–S1 segment, consistent with L5–S1 facet CF about 1.3 to 4 times higher than those measured for the L4–L5 segment. For the other movements and few stages, the L4–L5 ROM was significantly lower that of the L5–S1 segment. ROM and CF provide important baseline data for more accurate calibration of FE models and to understand the role that their structures play in lower lumbar spine mechanics
publishDate	2016
dc.date.issued.none.fl_str_mv	2016
dc.date.accessioned.none.fl_str_mv	2019-09-04T21:47:12Z
dc.date.available.none.fl_str_mv	2019-09-04T21:47:12Z
dc.type.spa.fl_str_mv	Artículo de revista
dc.type.coar.fl_str_mv	http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coarversion.fl_str_mv	http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.coar.eng.fl_str_mv	http://purl.org/coar/resource_type/c_6501
dc.type.content.eng.fl_str_mv	Text
dc.type.driver.eng.fl_str_mv	info:eu-repo/semantics/article
dc.type.redcol.eng.fl_str_mv	http://purl.org/redcol/resource_type/ARTREF
dc.type.version.eng.fl_str_mv	info:eu-repo/semantics/publishedVersion
format	http://purl.org/coar/resource_type/c_6501
status_str	publishedVersion
dc.identifier.issn.spa.fl_str_mv	1873-2380 (en línea) 0021-9290 (impresa)
dc.identifier.uri.none.fl_str_mv	http://hdl.handle.net/10614/11047
dc.identifier.doi.eng.fl_str_mv	https://doi.org/10.1016/j.jbiomech.2016.02.050
dc.identifier.instname.spa.fl_str_mv	Universidad Autónoma de Occidente
dc.identifier.reponame.spa.fl_str_mv	repositorio Educativo Digital UAO
identifier_str_mv	1873-2380 (en línea) 0021-9290 (impresa) Universidad Autónoma de Occidente repositorio Educativo Digital UAO
url	http://hdl.handle.net/10614/11047 https://doi.org/10.1016/j.jbiomech.2016.02.050
dc.language.iso.eng.fl_str_mv	eng
language	eng
dc.relation.citationendpage.none.fl_str_mv	1254
dc.relation.citationissue.none.fl_str_mv	7
dc.relation.citationstartpage.none.fl_str_mv	1248
dc.relation.citationvolume.none.fl_str_mv	49
dc.relation.cites.spa.fl_str_mv	Jaramillo, H. E., Puttlitz, C. M., McGilvray, K., & García, J. J. (2016). Characterization of the L4–L5–S1 motion segment using the stepwise reduction method. Journal of biomechanics, 49(7), pp. 1248-1254
dc.relation.ispartofjournal.spa.fl_str_mv	Journal of biomechanics
dc.relation.references.spa.fl_str_mv	Adams, M.A., Hutton, W.C., 1981. The relevance of torsion to the mechanical derangement of the lumbar spine. Spine 6, 241–248 Adams, M.A., Hutton, W.C., Stott, J.R.R., 1980. The resistance to flexion of the lumbar intervertebral joint. Spine 5, 245–253 Adams, Michael A., Bogduk, Nikolai, Burton, Kim, Dolan, Patricia, 2012. The Biomechanics of Back Pain, 3rd ed. Churchill Livingstone, Edinburgh Bogduk, N., 1995. Clinical Anatomy of the Lumbar Spine & Sacrum (WWW Document). ⟨http://www.lavoisier.fr/livre/notice.asp?id¼OKKW2RAORR6OWX⟩ (accessed 8.14.12) Devin Leahy, P., Puttlitz, C.M., 2012. The effects of ligamentous injury in the human lower cervical spine. J. Biomech. 45, 2668–2672. http://dx.doi.org/10.1016/j. jbiomech.2012.08.012 Goel, V.K., Clausen, J.D., 1998. Prediction of load sharing among spinal components of a C5–C6 motion segment using the finite element approach. Spine 23, 684–691 Griffith, J.F., Wang, Y.-X.J., Antonio, G.E., Choi, K.C., Yu, A., Ahuja, A.T., Leung, P.C., 2007. Modified pfirrmann grading system for lumbar intervertebral disc degeneration. Spine 32, E708–E712. http://dx.doi.org/10.1097/BRS.0b013e31815a59a0 Guan, Y., Yoganandan, N., Moore, J., Pintar, F.A., Zhang, J., Maiman, D.J., Laud, P., 2007. Moment–rotation responses of the human lumbosacral spinal column. J. Biomech. 40, 1975–1980. http://dx.doi.org/10.1016/j.jbiomech.2006.09.027 Harris, M., Morberg, P., Bruce, W.J., Walsh, W., 1999. An improved method for measuring tibiofemoral contact areas in total knee arthroplasty: a comparison of K-scan sensor and Fuji film. J. Biomech. 32, 951–958. http://dx.doi.org/ 10.1016/S0021-9290(99)00072-X Heuer, F., Schmidt, H., Wilke, H.-J., 2008. Stepwise reduction of functional spinal structures increase disc bulge and surface strains. J. Biomech. 41, 1953–1960. http://dx.doi.org/10.1016/j.jbiomech.2008.03.023 Heuer, F., Schmidt, H., Claes, L., Wilke, H.-J., 2007a. Stepwise reduction of functional spinal structures increase vertebral translation and intradiscal pressure. J. Biomech. 40, 795–803. http://dx.doi.org/10.1016/j.jbiomech.2006.03.016 Heuer, F., Schmidt, H., Klezl, Z., Claes, L., Wilke, H.-J., 2007b. Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle. J. Biomech. 40, 271–280. http://dx.doi.org/10.1016/j.jbiomech.2006.01.007 Panjabi, M.M., Oxland, T.R., Yamamoto, I., Crisco, J.J., 1994. Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load–displacement curves. J. Bone Jt. Surg. – Ser. A 76, 413–424 Panjabi, M., 1989. How does posture affect coupling in the lumbar spine? Spine 14, 1002–1011 (WWW Document) (accessed 8.15.12), http://journals.lww.com/spine journal/Fulltext/1989/09000/How_Does_Posture_Affect_Coupling_in_the_Lumbar.15. aspx Pfirrmann, C.W., Metzdorf, A., Zanetti, M., Hodler, J., Boos, N., 2001. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26, 1873–1878 Pintar, F.A., Yoganandan, N., Myers, T., Elhagediab, A., Sances Jr., A., 1992. Biomechanical properties of human lumbar spine ligaments. J. Biomech. 25, 1351–1356. http://dx.doi.org/10.1016/0021-9290(92)90290-H. Posner, I., White, A.A., Edwards, W.T., Hayes, W.C., 1982. A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine 7, 374–389 Saleem, S., Aslam, H.M., Rehmani, M.A.K., Raees, A., Alvi, A.A., Ashraf, J., 2013. Lumbar disc degenerative disease: disc degeneration symptoms and magnetic resonance image findings. Asian Spine J. 7, 322–334. http://dx.doi.org/10.4184/ asj.2013.7.4.322 Schmidt, H., Heuer, F., Drumm, J., Klezl, Z., Claes, L., Wilke, H.-J., 2007. Application of a calibration method provides more realistic results for a finite element model of a lumbar spinal segment. Clin. Biomech. 22, 377–384. http://dx.doi.org/ 10.1016/j.clinbiomech.2006.11.008 Shao, Z., Rompe, G., Schiltenwolf, M., 2002. Radiographic changes in the lumbar intervertebral discs and lumbar vertebrae with age. Spine 27, 263–268 Shirazi-Adl, A., 1994. Nonlinear stress analysis of the whole lumbar spine in torsion —mechanics of facet articulation. J. Biomech. 27, 289–299. http://dx.doi.org/ 10.1016/0021-9290(94)90005-1 Tencer, A.F., Ahmed, A.M., Burke, D.L., 1982. Some static mechanical properties of the lumbar intervertebral joint, intact and injured. J. Biomech. Eng. 104, 193–201 Van Schaik, J.P.J., Verbiest, H., Van Schaik, F.D.J., 1985. The orientation of laminae and facet joints in the lower lumbar spine. Spine 10, 59–63 Wilson, D.C., Niosi, C.A., Zhu, Q.A., Oxland, T.R., Wilson, D.R., 2006. Accuracy and repeatability of a new method for measuring facet loads in the lumbar spine. J. Biomech. 39, 348–353. http://dx.doi.org/10.1016/j.jbiomech.2004.12.011 Wilson, D.R., Apreleva, M.V., Eichler, M.J., Harrold, F.R., 2003. Accuracy and repeatability of a pressure measurement system in the patellofemoral joint. J. Biomech. 36, 1909–1915. http://dx.doi.org/10.1016/S0021-9290(03)00105-2 Yamamoto, I., Panjabi, M., Crisco, T., Oxland, T., 1989. Three-dimensional movements of the whole lumbar spine. J. Biomech. 22, 1103. http://dx.doi.org/ 10.1016/0021-9290(89)90523-X
dc.rights.spa.fl_str_mv	Derechos Reservados - Elsevier Ltd
dc.rights.coar.fl_str_mv	http://purl.org/coar/access_right/c_abf2
dc.rights.uri.eng.fl_str_mv	https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.accessrights.eng.fl_str_mv	info:eu-repo/semantics/openAccess
dc.rights.creativecommons.spa.fl_str_mv	Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
rights_invalid_str_mv	Derechos Reservados - Elsevier Ltd https://creativecommons.org/licenses/by-nc-nd/4.0/ Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv	openAccess
dc.format.eng.fl_str_mv	application/pdf
dc.format.extent.spa.fl_str_mv	7 páginas
dc.format.mimetype.eng.fl_str_mv	application/pdf
dc.publisher.eng.fl_str_mv	Elsevier Ltd
institution	Universidad Autónoma de Occidente
bitstream.url.fl_str_mv	https://red.uao.edu.co/bitstreams/aec2180a-717c-4b3b-8fe4-2e7a49e95c06/download https://red.uao.edu.co/bitstreams/db5a6ab9-a361-4e62-a90a-90ca0b4ba6e2/download
bitstream.checksum.fl_str_mv	4460e5956bc1d1639be9ae6146a50347 20b5ba22b1117f71589c7318baa2c560
bitstream.checksumAlgorithm.fl_str_mv	MD5 MD5
repository.name.fl_str_mv	Repositorio Digital Universidad Autonoma de Occidente
repository.mail.fl_str_mv	repositorio@uao.edu.co
_version_	1814259939921625088
spelling	Jaramillo Suárez, Héctor Enriquevirtual::2372-1Puttlitz, Christian M.cb3497001c1cdd32c772930fb0ab0106García Álvarez, José Jaime56b4754cf01bc1970626b07be8e549b9Mcgilvray, Kirk1c1724fba1d83787cfb1b10f21071dfc2019-09-04T21:47:12Z2019-09-04T21:47:12Z20161873-2380 (en línea)0021-9290 (impresa)http://hdl.handle.net/10614/11047https://doi.org/10.1016/j.jbiomech.2016.02.050Universidad Autónoma de Occidenterepositorio Educativo Digital UAOThe two aims of this study were to generate data for a more accurate calibration of finite element models including the L5–S1 segment, and to find mechanical differences between the L4–L5 and L5–S1 segments. Then, the range of motion (ROM) and facet forces for the L4–S1 segment were measured using the stepwise reduction method. This consists of sequentially testing and reducing each segment in nine stages by cutting the ligaments, facet capsules, and removing the nucleus. Five L4–S1 human segments (median: 65 years, range: 53–84 years, SD=11.0 years) were loaded under a maximum pure moment of 8 N m. The ROM was measured using stereo-photogrammetry via tracking of three markers and the facet contact forces (CF) were measured using a Tekscan system. The ROM for the L4–L5 segment and all stages showed good agreement with published data. The major differences in ROM between the L4–L5 and L5–S1 segments were found for lateral bending and all stages, for which the L4–L5 ROM was about 1.5–3 times higher than that of the L5–S1 segment, consistent with L5–S1 facet CF about 1.3 to 4 times higher than those measured for the L4–L5 segment. For the other movements and few stages, the L4–L5 ROM was significantly lower that of the L5–S1 segment. ROM and CF provide important baseline data for more accurate calibration of FE models and to understand the role that their structures play in lower lumbar spine mechanicsapplication/pdf7 páginasapplication/pdfengElsevier LtdDerechos Reservados - Elsevier Ltdhttps://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessAtribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)http://purl.org/coar/access_right/c_abf2Characterization of the L4-L5-S1 motion segment using the stepwise reduction methodArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTREFinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85BiomecánicaMovimiento de rotaciónMecánica humanaBiomechanicsRotational motionHuman mechanicsL4–L5–S1 segmentStepwise reduction methodRange of motionContact forces12547124849Jaramillo, H. E., Puttlitz, C. M., McGilvray, K., & García, J. J. (2016). Characterization of the L4–L5–S1 motion segment using the stepwise reduction method. Journal of biomechanics, 49(7), pp. 1248-1254Journal of biomechanicsAdams, M.A., Hutton, W.C., 1981. The relevance of torsion to the mechanical derangement of the lumbar spine. Spine 6, 241–248Adams, M.A., Hutton, W.C., Stott, J.R.R., 1980. The resistance to flexion of the lumbar intervertebral joint. Spine 5, 245–253Adams, Michael A., Bogduk, Nikolai, Burton, Kim, Dolan, Patricia, 2012. The Biomechanics of Back Pain, 3rd ed. Churchill Livingstone, EdinburghBogduk, N., 1995. Clinical Anatomy of the Lumbar Spine & Sacrum (WWW Document). ⟨http://www.lavoisier.fr/livre/notice.asp?id¼OKKW2RAORR6OWX⟩ (accessed 8.14.12)Devin Leahy, P., Puttlitz, C.M., 2012. The effects of ligamentous injury in the human lower cervical spine. J. Biomech. 45, 2668–2672. http://dx.doi.org/10.1016/j. jbiomech.2012.08.012Goel, V.K., Clausen, J.D., 1998. Prediction of load sharing among spinal components of a C5–C6 motion segment using the finite element approach. Spine 23, 684–691Griffith, J.F., Wang, Y.-X.J., Antonio, G.E., Choi, K.C., Yu, A., Ahuja, A.T., Leung, P.C., 2007. Modified pfirrmann grading system for lumbar intervertebral disc degeneration. Spine 32, E708–E712. http://dx.doi.org/10.1097/BRS.0b013e31815a59a0Guan, Y., Yoganandan, N., Moore, J., Pintar, F.A., Zhang, J., Maiman, D.J., Laud, P., 2007. Moment–rotation responses of the human lumbosacral spinal column. J. Biomech. 40, 1975–1980. http://dx.doi.org/10.1016/j.jbiomech.2006.09.027Harris, M., Morberg, P., Bruce, W.J., Walsh, W., 1999. An improved method for measuring tibiofemoral contact areas in total knee arthroplasty: a comparison of K-scan sensor and Fuji film. J. Biomech. 32, 951–958. http://dx.doi.org/ 10.1016/S0021-9290(99)00072-XHeuer, F., Schmidt, H., Wilke, H.-J., 2008. Stepwise reduction of functional spinal structures increase disc bulge and surface strains. J. Biomech. 41, 1953–1960. http://dx.doi.org/10.1016/j.jbiomech.2008.03.023Heuer, F., Schmidt, H., Claes, L., Wilke, H.-J., 2007a. Stepwise reduction of functional spinal structures increase vertebral translation and intradiscal pressure. J. Biomech. 40, 795–803. http://dx.doi.org/10.1016/j.jbiomech.2006.03.016Heuer, F., Schmidt, H., Klezl, Z., Claes, L., Wilke, H.-J., 2007b. Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle. J. Biomech. 40, 271–280. http://dx.doi.org/10.1016/j.jbiomech.2006.01.007Panjabi, M.M., Oxland, T.R., Yamamoto, I., Crisco, J.J., 1994. Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load–displacement curves. J. Bone Jt. Surg. – Ser. A 76, 413–424Panjabi, M., 1989. How does posture affect coupling in the lumbar spine? Spine 14, 1002–1011 (WWW Document) (accessed 8.15.12), http://journals.lww.com/spine journal/Fulltext/1989/09000/How_Does_Posture_Affect_Coupling_in_the_Lumbar.15. aspxPfirrmann, C.W., Metzdorf, A., Zanetti, M., Hodler, J., Boos, N., 2001. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26, 1873–1878Pintar, F.A., Yoganandan, N., Myers, T., Elhagediab, A., Sances Jr., A., 1992. Biomechanical properties of human lumbar spine ligaments. J. Biomech. 25, 1351–1356. http://dx.doi.org/10.1016/0021-9290(92)90290-H.Posner, I., White, A.A., Edwards, W.T., Hayes, W.C., 1982. A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine 7, 374–389Saleem, S., Aslam, H.M., Rehmani, M.A.K., Raees, A., Alvi, A.A., Ashraf, J., 2013. Lumbar disc degenerative disease: disc degeneration symptoms and magnetic resonance image findings. Asian Spine J. 7, 322–334. http://dx.doi.org/10.4184/ asj.2013.7.4.322Schmidt, H., Heuer, F., Drumm, J., Klezl, Z., Claes, L., Wilke, H.-J., 2007. Application of a calibration method provides more realistic results for a finite element model of a lumbar spinal segment. Clin. Biomech. 22, 377–384. http://dx.doi.org/ 10.1016/j.clinbiomech.2006.11.008Shao, Z., Rompe, G., Schiltenwolf, M., 2002. Radiographic changes in the lumbar intervertebral discs and lumbar vertebrae with age. Spine 27, 263–268Shirazi-Adl, A., 1994. Nonlinear stress analysis of the whole lumbar spine in torsion —mechanics of facet articulation. J. Biomech. 27, 289–299. http://dx.doi.org/ 10.1016/0021-9290(94)90005-1Tencer, A.F., Ahmed, A.M., Burke, D.L., 1982. Some static mechanical properties of the lumbar intervertebral joint, intact and injured. J. Biomech. Eng. 104, 193–201Van Schaik, J.P.J., Verbiest, H., Van Schaik, F.D.J., 1985. The orientation of laminae and facet joints in the lower lumbar spine. Spine 10, 59–63Wilson, D.C., Niosi, C.A., Zhu, Q.A., Oxland, T.R., Wilson, D.R., 2006. Accuracy and repeatability of a new method for measuring facet loads in the lumbar spine. J. Biomech. 39, 348–353. http://dx.doi.org/10.1016/j.jbiomech.2004.12.011Wilson, D.R., Apreleva, M.V., Eichler, M.J., Harrold, F.R., 2003. Accuracy and repeatability of a pressure measurement system in the patellofemoral joint. J. Biomech. 36, 1909–1915. http://dx.doi.org/10.1016/S0021-9290(03)00105-2Yamamoto, I., Panjabi, M., Crisco, T., Oxland, T., 1989. Three-dimensional movements of the whole lumbar spine. J. Biomech. 22, 1103. http://dx.doi.org/ 10.1016/0021-9290(89)90523-XPublicationada2f35e-57bd-4bbb-91d3-e197573bfab8virtual::2372-1ada2f35e-57bd-4bbb-91d3-e197573bfab8virtual::2372-1https://scholar.google.com.co/citations?user=GEzrsjQAAAAJ&hl=esvirtual::2372-10000-0002-7324-9478virtual::2372-1https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000144967virtual::2372-1CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805https://red.uao.edu.co/bitstreams/aec2180a-717c-4b3b-8fe4-2e7a49e95c06/download4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81665https://red.uao.edu.co/bitstreams/db5a6ab9-a361-4e62-a90a-90ca0b4ba6e2/download20b5ba22b1117f71589c7318baa2c560MD5310614/11047oai:red.uao.edu.co:10614/110472024-05-10 10:46:06.396https://creativecommons.org/licenses/by-nc-nd/4.0/Derechos Reservados - Elsevier Ltdmetadata.onlyhttps://red.uao.edu.coRepositorio Digital Universidad Autonoma de Occidenterepositorio@uao.edu.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

Characterization of the L4-L5-S1 motion segment using the stepwise reduction method

Publicaciones similares