Recent advances in lumbar spinal mechanics and their clinical significance

Of the many problems associated with low back pain, those which are most amenable to biomechanical investigation are identified. Recent advances in lumbar spinal mechanics are then reviewed in five sections dealing with mechanical function, mechanisms of failure, movements in vivo, loading in vivo, and the biological consequences of mechanical loading. The discussion suggests that mechanical fatigue damage may frequently be the underlying cause of low back pain, even when degenerative changes are evident in the tissues, and the review ends by suggesting some priority areas for future research.