Mechanical Evaluation of Human Cadaveric Lumbar Soft Tissues Suggests Possible Physiological Stress Shielding Within Musculoskeletal Soft Tissues by the Thoracolumbar Fascia

Objective:
This study investigates the potential for stress shielding within musculoskeletal soft tissues through analysis of stress distributions between lumbar fascial and muscle tissues via mechanical testing.
Methods:
Using a custom apparatus, 51 posterior thoracolumbar fascia (TLF) samples and 18 erector spinae (ES) cadaveric samples underwent tensile testing involving three loading-unloading cycles, followed by loading to 6% strain, to mechanically characterize samples. Parallel tensile testing using 20 pairs of two TLF samples, and seven pairs of TLF and ES samples was then conducted for stress distribution analysis between tissues. P<0.05 was deemed significant.
Results:
The TLF and ES exhibited an average elastic modulus of 150.9 MPa and 0.69 MPa, respectively. At 6% strain, parallel testing of the TLF pairs yielded an average tensile stress of 8.49 MPa and 1.7MPa (p<0.001) exhibited by the stiffer and less stiff TLF samples, respectively. Similarly, TLF-ES parallel testing resulted in average tensile stresses of 7.19 MPa and 0.079 MPa of the TLF and ES (p<0.002).
Conclusion:
Results suggest elevated loading towards stiffer TLF samples relative to less stiff TLF and ES samples. In soft tissues affected by LBP, skewed stress distributions may result in the TLF withstanding the majority of stress, yielding cyclical stress shielding that may contribute to and/or promote LBP.
Significance:
This novel study demonstrates a potential load allocation bias towards the TLF, laying the foundation for stress shielding within lumbar musculoskeletal soft tissues affected by degenerative musculoskeletal conditions.