Recent work utilizing ultrasound imaging demonstrated that individuals with low back pain (LBP) have increased thickness and decreased mobility of the thoracolumbar fascia (TLF), an indication that the TLF may play a role in LBP. This study used a porcine injury model (microsurgically induced local injury)—shown to produce similar results to those observed in humans with LBP—to test the hypothesis that TLF mechanical properties may also be altered in patients with LBP. Perimuscular TLF tissue was harvested from the noninjured side of vertebral level L3-4 in pigs randomized into either control (n = 5) or injured (n = 5) groups. All samples were tested with a displacement-controlled biaxial testing system using the following protocol: cyclic loading/unloading and stress relaxation tests at 25%, 35%, and then 45% of their resting length. Tissue anisotropy was also explored by comparing responses to loading in longitudinal and transverse orientations. Tissues from injured pigs were found to have greater stretch–stretch ratio moduli (measure of tissue stiffness), less energy dissipation, and less stress decay compared to tissues from control pigs. Responses across these variables also depended on loading orientation. Clinical significance: these findings suggest that a focal TLF injury can produce impairments in tissue mechanical properties away from the injured area itself. This could contribute to some of the functional abnormalities observed in human LBP.
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October 2018
Research-Article
Acute Surgical Injury Alters the Tensile Properties of Thoracolumbar Fascia in a Porcine Model
Erika Nelson-Wong,
Erika Nelson-Wong
School of Physical Therapy,
Regis University,
3333 Regis Boulevard G4,
Denver, CO 80221
e-mail: enelsonw@regis.edu
Regis University,
3333 Regis Boulevard G4,
Denver, CO 80221
e-mail: enelsonw@regis.edu
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Michal Glinka,
Michal Glinka
Faculty of Applied Health Sciences,
University of Waterloo,
200 University Avenue West,
Waterloo, ON N2 L 3G1, Canada
e-mail: mglinka@uwaterloo.ca
University of Waterloo,
200 University Avenue West,
Waterloo, ON N2 L 3G1, Canada
e-mail: mglinka@uwaterloo.ca
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Mamiko Noguchi,
Mamiko Noguchi
Faculty of Applied Health Sciences,
University of Waterloo,
Waterloo, ON N2 L 3G1, Canada
e-mail: mnoguchi@uwaterloo.ca
University of Waterloo,
200 University Avenue West
,Waterloo, ON N2 L 3G1, Canada
e-mail: mnoguchi@uwaterloo.ca
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Helene Langevin,
Helene Langevin
Osher Center for Integrative Medicine
at Harvard Medical School and
Brigham and Women's Hospital,
75 Francis Street,
Boston, MA 02115
e-mail: hlangevin@partners.org
at Harvard Medical School and
Brigham and Women's Hospital,
75 Francis Street,
Boston, MA 02115
e-mail: hlangevin@partners.org
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Gary J. Badger,
Gary J. Badger
Department of Medical Biostatistics,
College of Medicine,
University of Vermont,
Burlington, VT 05405
e-mail: Gary.badger@uvm.edu
College of Medicine,
University of Vermont,
Burlington, VT 05405
e-mail: Gary.badger@uvm.edu
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Jack P. Callaghan
Jack P. Callaghan
Faculty of Applied Health Sciences,
University of Waterloo,
Waterloo, ON N2 L 3G1, Canada
e-mail: callagha@uwaterloo.ca
University of Waterloo,
200 University Avenue West
,Waterloo, ON N2 L 3G1, Canada
e-mail: callagha@uwaterloo.ca
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Erika Nelson-Wong
School of Physical Therapy,
Regis University,
3333 Regis Boulevard G4,
Denver, CO 80221
e-mail: enelsonw@regis.edu
Regis University,
3333 Regis Boulevard G4,
Denver, CO 80221
e-mail: enelsonw@regis.edu
Michal Glinka
Faculty of Applied Health Sciences,
University of Waterloo,
200 University Avenue West,
Waterloo, ON N2 L 3G1, Canada
e-mail: mglinka@uwaterloo.ca
University of Waterloo,
200 University Avenue West,
Waterloo, ON N2 L 3G1, Canada
e-mail: mglinka@uwaterloo.ca
Mamiko Noguchi
Faculty of Applied Health Sciences,
University of Waterloo,
Waterloo, ON N2 L 3G1, Canada
e-mail: mnoguchi@uwaterloo.ca
University of Waterloo,
200 University Avenue West
,Waterloo, ON N2 L 3G1, Canada
e-mail: mnoguchi@uwaterloo.ca
Helene Langevin
Osher Center for Integrative Medicine
at Harvard Medical School and
Brigham and Women's Hospital,
75 Francis Street,
Boston, MA 02115
e-mail: hlangevin@partners.org
at Harvard Medical School and
Brigham and Women's Hospital,
75 Francis Street,
Boston, MA 02115
e-mail: hlangevin@partners.org
Gary J. Badger
Department of Medical Biostatistics,
College of Medicine,
University of Vermont,
Burlington, VT 05405
e-mail: Gary.badger@uvm.edu
College of Medicine,
University of Vermont,
Burlington, VT 05405
e-mail: Gary.badger@uvm.edu
Jack P. Callaghan
Faculty of Applied Health Sciences,
University of Waterloo,
Waterloo, ON N2 L 3G1, Canada
e-mail: callagha@uwaterloo.ca
University of Waterloo,
200 University Avenue West
,Waterloo, ON N2 L 3G1, Canada
e-mail: callagha@uwaterloo.ca
Manuscript received September 28, 2017; final manuscript received May 20, 2018; published online July 2, 2018. Assoc. Editor: David Corr.
J Biomech Eng. Oct 2018, 140(10): 101012 (7 pages)
Published Online: July 2, 2018
Article history
Received:
September 28, 2017
Revised:
May 20, 2018
Citation
Nelson-Wong, E., Glinka, M., Noguchi, M., Langevin, H., Badger, G. J., and Callaghan, J. P. (July 2, 2018). "Acute Surgical Injury Alters the Tensile Properties of Thoracolumbar Fascia in a Porcine Model." ASME. J Biomech Eng. October 2018; 140(10): 101012. https://doi.org/10.1115/1.4040452
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