Beth
A. Winkelstein, Ph.D.
winkelst@seas.upenn.edu
Associate Professor of Bioengineering
B.S.E., Bioengineering, University of Pennsylvania, 1993
Ph.D., Biomedical Engineering, Duke University, 1999
Research Interests
The current understanding of painful neck injury mechanisms remains
quite limited, drawing largely on clinical and epidemiological speculations.
The broad goal of the work in our laboratory is to understand the
mechanisms of injury that produce whiplash, sports-related, and
other painful injuries. By combining biomechanical and immunological
techniques we can define the relationships between injury to the
cervical spine/neck and physiological cascades of persistent pain.
Particular emphasis is placed on understanding injury to individual
structures in the neck, such as the facet joints, nerve roots and
spinal cord and how mechanical loading to these structures elicits
pain. Through this work we can begin to develop thresholds for mechanical
injury that produce persistent pain; and work towards a definition
of the neck's tolerance for painful injury.
Additional research efforts are aimed at understanding the role
of biomechanics in the neuroimmunologic changes of the central nervous
system that contribute to persistent pain. Understanding neck pain
mechanisms requires merging both biomechanics and neuroimmunology.
As such, work in our laboratory integrates experimental and theoretical
approaches in an effort to understand biomechanics of pain. This
requires integrated research at both the cellular and macroscopic
tissue levels and efforts are focused on describing the mechanical
and physiological responses at both of these levels.
Applications of current work are in the areas of automotive and
whiplash-related injury and sports injuries. Studies in our laboratory
complement other related clinical studies investigating neck pain
and have implications for design efforts in automobiles that are
aimed at preventing whiplash injuries. Future efforts will also
help determine the most effective pharmacological treatments and
clinical management strategies for neck pain.
Selected Publications
Winkelstein, B.A., Weinstein, J.N., DeLeo, J.A., "The Role
of Mechanical Deformation in Lumbar Radiculopathy: An In Vivo Model."
Spine, 27(1):27-33, 2002 (selected by Dannemiller Memorial Educational
Foundation for publication in AnalgesiaFile).
Winkelstein, B.A., Rutkowski, M.D., Sweitzer, S.M., Pahl, J.L.,
DeLeo, J.A., "Nerve Injury Proximal or Distal to the DRG Induces
Similar Spinal Glial Activation and Selective Cytokine Expression
but Differential Behavioral Responses to Pharmacological Treatment."
Journal of Comparative Neurology, 439(2):127-139, 2001.
Winkelstein, B.A., Myers, B.S., "Importance of Nonlinear and
Multivariable Flexibility Coefficients in the Prediction of Human
Cervical Spine Motion." Journal of Biomechanical Engineering,
October, 2002.
Siegmund, G.P., Myers, B.S., Davis, M.B., Bohnet, H.F., Winkelstein,
B.A., "Mechanical Evidence of Cervical Facet Capsule Injury
During Whiplash: A Cadaveric Study Using Combined Shear, Compression
and Extension Loading." Spine, 26(10):2095-2101, 2001.
Winkelstein, B.A., Rutkowski, M.D., Weinstein, J.N., DeLeo, J.A.,
"Quantification of Neural Tissue Injury in a Rat Radiculopathy
Model: Comparison of Local Deformation, Behavioral Outcomes, and
Spinal Cytokine mRNA for Two Surgeons." Journal of Neuroscience
Methods, 111(1):49-57, 2001.
Winkelstein, B.A., McLendon, R.E., Barbir, A., Myers, B.S., "An
Anatomic Investigation of the Cervical Facet Capsule Quantifying
Muscle Insertion Area." Journal of Anatomy, 198:455-461, 2001.
Winkelstein, B.A., Nightingale, R.W., Richardson, W.J., Myers,
B.S., "The Cervical Facet Capsule and Its Role in Whiplash
Injury: A Biomechanical Investigation." Spine, 25(10):1238-1246,
2000.
Winkelstein, B.A., Myers, B.S., "The Biomechanics of Cervical
Spine Injury and Implications for Injury Prevention." Medicine
& Science in Sports & Exercise, 29(7):S246-S255, 1997.
Bioengineering
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