The examination of stress shielding in a finite element lumbar spine inclusive of the thoracolumbar fascia.
Biomechanics
Finite element analysis
Low back pain
Lumbar fascia
Physiological stress shielding
Journal
Medical & biological engineering & computing
ISSN: 1741-0444
Titre abrégé: Med Biol Eng Comput
Pays: United States
ID NLM: 7704869
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
26
11
2020
accepted:
04
07
2021
pubmed:
18
7
2021
medline:
30
9
2021
entrez:
17
7
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 34273037
doi: 10.1007/s11517-021-02408-9
pii: 10.1007/s11517-021-02408-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1621-1628Subventions
Organisme : Fonds de Recherche du Québec - Nature et Technologies
ID : FQRNT NC-205220
Organisme : Natural Sciences and Engineering Research Council of Canada
ID : GP514085-17
Informations de copyright
© 2021. International Federation for Medical and Biological Engineering.
Références
Andersson GBJ (1999) Epidemiological features of chronic low-back pain. The Lancet 354:581–585
doi: 10.1016/S0140-6736(99)01312-4
Hestbaek L, Leboeuf-Yde C, Manniche C (2003) Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 12:149–165. https://doi.org/10.1007/s00586-002-0508-5
doi: 10.1007/s00586-002-0508-5
pubmed: 12709853
pmcid: 3784852
Croft PR, Macfarlane GJ, Papageorgiou AC et al (1998) Outcome of low back pain in general practice. Br Med J 316:1356–1359. https://doi.org/10.1136/bmj.317.7165.1083
doi: 10.1136/bmj.317.7165.1083
Maher C, Underwood M, Buchbinder R (2017) Non-specific low back pain. The Lancet 389:736–747
doi: 10.1016/S0140-6736(16)30970-9
Katz JN (2006) Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Jt Surg 88:21–24. https://doi.org/10.2106/JBJS.E.01273
doi: 10.2106/JBJS.E.01273
Deyo RA, Weinstein JN (2001) Low back pain. N Engl J Med 344:363–370. https://doi.org/10.1136/bmj.322.7293.1027
doi: 10.1136/bmj.322.7293.1027
pubmed: 11172169
Borenstein D, Calin A (2012) Causes of low back pain. In: Fast facts: low back pain, 2nd ed. Heath Press Ltd., Abingdon, UK, pp 46–72
Driscoll M, Blyum L (2011) The presence of physiological stress shielding in the degenerative cycle of musculoskeletal disorders. J Bodyw Mov Ther 15:335–342. https://doi.org/10.1016/j.jbmt.2010.05.002
doi: 10.1016/j.jbmt.2010.05.002
pubmed: 21665110
Driscoll M, Aubin CE, Moreau A et al (2009) The role of spinal concave-convex biases in the progression of idiopathic scoliosis. Eur Spine J 18:180–187. https://doi.org/10.1007/s00586-008-0862-z
doi: 10.1007/s00586-008-0862-z
pubmed: 19130096
pmcid: 2899346
Langevin HM, Konofagou EE, Badger GJ et al (2011) Reduced thoracolumbar fascia shear strain in human chronic low back pain. BMC Musculoskelet Disord 12:1–11. https://doi.org/10.1186/1471-2474-12-203
doi: 10.1186/1471-2474-12-203
Kamaz M, Kireşi D, Oǧuz H et al (2007) CT measurement of trunk muscle areas in patients with chronic low back pain. Diagn Interv Radiol 13:144–148
pubmed: 17846989
Masaki M, Aoyama T, Murakami T et al (2017) Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers. Clin Biomech 49:128–133. https://doi.org/10.1016/j.clinbiomech.2017.09.008
doi: 10.1016/j.clinbiomech.2017.09.008
Masaki M, Ji X, Yamauchi T et al (2019) Effects of the trunk position on muscle stiffness that reflects elongation of the lumbar erector spinae and multifidus muscles: an ultrasonic shear wave elastography study. Eur J Appl Physiol 119:1085–1091. https://doi.org/10.1007/s00421-019-04098-6
doi: 10.1007/s00421-019-04098-6
pubmed: 30747266
Cholewicki J, McGill SM (1996) Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain. Clin Biomech 11:1–15. https://doi.org/10.1016/0268-0033(95)00035-6
doi: 10.1016/0268-0033(95)00035-6
Rayfield EJ (2007) Finite element analysis and understanding the biomechanics and evolution of living and fossil organisms. Annu Rev Earth Planet Sci 35:541–576. https://doi.org/10.1192/bjp.112.483.211-a
doi: 10.1192/bjp.112.483.211-a
Driscoll M (2019) The impact of the finite element method on medical device design. J Med Biol Eng 39:171–172. https://doi.org/10.1192/bjp.112.483.211-a
doi: 10.1192/bjp.112.483.211-a
American Society of Mechanical Engineers (2018) Assessing credibility of computational modeling through verification and validation: application to medical devices. American Society of Mechanical Engineers, New York, NY, USA
El Bojairami I, El Monajjed K, Driscoll M (2020) Development and validation of a timely and representative finite element human spine model for biomechanical simulations. Sci Rep 10:1–16. https://doi.org/10.1038/s41598-020-77469-1
doi: 10.1038/s41598-020-77469-1
Smit T, Odgaard A, Schneider E (1999) Structure and function of vertebral trabecular bone. Spine 22:2823–2833
doi: 10.1097/00007632-199712150-00005
Yang H, Nawathe S, Fields AJ, Keaveny TM (2012) Micromechanics of the human vertebral body for forward flexion. J Biomech 45:2142–2148. https://doi.org/10.1016/j.jbiomech.2012.05.044
doi: 10.1016/j.jbiomech.2012.05.044
pubmed: 22704826
pmcid: 3415303
Bonilla KA, Pardes AM, Freedman BR, Soslowsky LJ (2018) Supraspinatus tendons have different mechanical properties across sex. J Biomech Eng 141:011002. https://doi.org/10.1115/1.4041321
doi: 10.1115/1.4041321
Yahia LH, Pigeon P, DesRosiers EA (1993) Viscoelastic properties of the human lumbodorsal fascia. J Biomed Eng 15:425–429. https://doi.org/10.1016/0141-5425(93)90081-9
doi: 10.1016/0141-5425(93)90081-9
pubmed: 8231161
Creze M, Soubeyrand M, Yue JL et al (2018) Magnetic resonance elastography of the lumbar back muscles: a preliminary study. Clin Anat 31:514–520. https://doi.org/10.1002/ca.23065
doi: 10.1002/ca.23065
pubmed: 29446170
Marieb EN, Hoehn K (2013) The muscular system. In: Beauparlant S, Puttkamer G, Cutt S, et al (eds) Human anatomy & physiology, 9th ed. Pearson, Boston, USA, pp 319–386
Rohlmann A, Zander T, Rao M, Bergmann G (2009) Realistic loading conditions for upper body bending. J Biomech 42:884–890. https://doi.org/10.1016/j.jbiomech.2009.01.017
doi: 10.1016/j.jbiomech.2009.01.017
pubmed: 19268291
Lin RM, Yu CY, Chang ZJ, Su FC (1994) Flexion-extension rhythm in the lumbosacral spine. Spine 19:2204–2209. https://doi.org/10.1097/00007632-199410000-00015
doi: 10.1097/00007632-199410000-00015
pubmed: 7809755
Dreischarf M, Zander T, Shirazi-Adl A et al (2014) Comparison of eight published static finite element models of the intact lumbar spine: predictive power of models improves when combined together. J Biomech 47:1757–1766. https://doi.org/10.1016/j.jbiomech.2014.04.002
doi: 10.1016/j.jbiomech.2014.04.002
pubmed: 24767702
Wilke H, Neef P, Caimi M et al (1999) New in vivo measurements of pressures in the intervertebral disc in daily life. Spine 24:755–762
doi: 10.1097/00007632-199904150-00005
Wong KWN, Leong JCY, Chan MK et al (2004) The flexion-extension profile of lumbar spine in 100 healthy volunteers. Spine 29:1636–1641. https://doi.org/10.1097/01.BRS.0000132320.39297.6C
doi: 10.1097/01.BRS.0000132320.39297.6C
pubmed: 15284509
Schleip R, Naylor IL, Ursu D et al (2006) Passive muscle stiffness may be influenced by active contractility of intramuscular connective tissue. Med Hypotheses 66:66–71. https://doi.org/10.1016/j.mehy.2005.08.025
doi: 10.1016/j.mehy.2005.08.025
pubmed: 16209907
Danneels LA, Vanderstraeten GG, Cambier DC et al (2000) CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J 9:266–272
doi: 10.1007/s005860000190
Newell E, Driscoll M (2021) Investigation of physiological stress shielding within lumbar spinal tissue as a contributor to unilateral low back pain: a finite element study. Comput Biol Med 133:1–8. https://doi.org/10.1016/j.compbiomed.2021.104351
doi: 10.1016/j.compbiomed.2021.104351
Okubo K, Tamura T, Takagi T et al (2008) BodyParts3D: 3D structure database for anatomical concepts. Nucleic Acids Res 37:D782–D785. https://doi.org/10.1093/nar/gkn613
doi: 10.1093/nar/gkn613
pubmed: 18835852
pmcid: 2686534