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NP removal through enzymatic digestion is also commonly performed to initiate degenerative changes to study potential biological repair strategies. Experimental and computational studies have shown a decrease in disc stiffness with nucleotomy under single loading modalities, such as compression-only or bending-only loading. However, studies that apply more physiologically relevant loading conditions, such as compression in combination with bending or torsion, have shown contradicting results. We used a previously validated bone\u2013disc\u2013bone finite element model (Control) to create a Nucleotomy model to evaluate the effect of dual loading conditions (compression with torsion or bending) on intradiscal deformations. While disc joint stiffness decreased with nucleotomy under single loading conditions, as commonly reported in the literature, dual loading resulted in an increase in bending stiffness. More specifically, dual loading resulted in a 40% increase in bending stiffness under flexion and extension and a 25% increase in stiffness under lateral bending. The increase in bending stiffness was due to an increase and shift in compressive stress, where peak stresses migrated from the NP\u2013annulus interface to the outer annulus. In contrast, the decrease in torsional stiffness was due to greater fiber reorientation during compression. In general, large radial strains were observed with nucleotomy, suggesting an increased risk for delamination or degenerative remodeling. In conclusion, the effect of nucleotomy on disc mechanics depends on the type and complexity of applied loads.<\/jats:p>","DOI":"10.1115\/1.4050538","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T14:04:51Z","timestamp":1615989891000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":10,"title":["Intervertebral Disc Mechanics With Nucleotomy: Differences Between Simple and Dual Loading"],"prefix":"10.1115","volume":"143","author":[{"given":"Bo","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, University of California Berkeley, Etcheverry Hall, Berkeley, CA 94720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Klineberg","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, Davis, Davis Medical Center, Sacramento, CA 95817"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace D.","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of California Berkeley, 5122 Etcheverry Hall, #1740, Berkeley, CA 94720; Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA 94142"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"33","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"issue":"1","key":"2021042112333810500_bib1","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1089\/biores.2015.0034","article-title":"Tissue Engineering a Biological Repair Strategy for Lumbar Disc Herniation","volume":"4","year":"2015","journal-title":"BioResearch Open Access"},{"issue":"10","key":"2021042112333810500_bib2","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1016\/j.jbiomech.2008.04.037","article-title":"The Role of the Nucleus Pulposus in Neutral Zone Human Lumbar Intervertebral Disc Mechanics","volume":"41","year":"2008","journal-title":"J. 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