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The examination of stress shielding in a finite element lumbar spine inclusive of the thoracolumbar fascia

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Abstract

Despite the prevalence of low back pain (LBP) in society, the pathomechanism of LBP continues to elude researchers. LBP patients have demonstrated morphological and material property changes to their lumbar soft tissues, potentially leading to irregular load sharing within the lumbar spine. This study aims to analyze potential stress shielding consequential of augmented soft tissue properties via the comparison of a healthy and LBP finite element models. The models developed in this study include the vertebrae, intervertebral discs and soft tissues from L1–S1. Soft tissue morphology and material properties for the LBP model were augmented to reflect documented clinical findings. Model validation preceded testing and was confirmed through comparison to the available literature. Relative to the healthy model, the LBP model demonstrated an increase in stress by 15.6%, with 99.8% of this stress increase being distributed towards the thoracolumbar fascia. The majority of stress skewed towards the fascia may indicate a potential stress allocation bias whereby the lumbar muscles are unable to receive regular loading, leading to stress shielding. This load allocation bias and subsequent stress shielding may potentially contribute to the progression and pathomechanism of LBP but prospective studies would be required to make that link.

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Funding

This study was funded by the Fonds de Recherche du Québec – Nature et Technologies (FRQNT, grant no. NC-205220) and the Natural Science and Engineering Research Council (NSERC, grant no. NSERC GP514085-17).

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Authors and Affiliations

  1. Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 817 Sherbrooke St. W, Montréal, QC, H3A 0C3, Canada

    Emily Newell & Mark Driscoll

  2. Orthopaedic Research Laboratory, Research Institute MUHC, Montreal General Hospital, 1650 Cedar Ave, LS1.409, Montreal, QC, H3G 1A4, Canada

    Emily Newell & Mark Driscoll

Authors
  1. Emily Newell
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  2. Mark Driscoll
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Contributions

All authors contributed to the study conception and design. Methodology, data collection and analysis and validation were performed by Emily Newell. The first draft of the manuscript was written by Emily Newell. Review and editing were performed by all authors on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mark Driscoll.

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Newell, E., Driscoll, M. The examination of stress shielding in a finite element lumbar spine inclusive of the thoracolumbar fascia. Med Biol Eng Comput 59, 1621–1628 (2021). https://doi.org/10.1007/s11517-021-02408-9

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  • DOI: https://doi.org/10.1007/s11517-021-02408-9

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