Biomaterials for intervertebral disc regeneration and repair

Bowles, Robert D.; Setton, Lori A.

doi:10.1016/j.biomaterials.2017.03.013

Cited by 278 publications

(249 citation statements)

References 132 publications

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“…The Barricaid (Intrinsic Therapeutics, Inc., Woburn, Massachusetts), a shield within the annulus fibrosus secured to the inferior vertebral body (35) prevents reherniation (36) and protects the facet joint (37), but does not seal AF defects. Developing biomaterials that can seal AF defects is an area of active research (38). Fibrin crosslinked with genipin (FibGen) is an injectable, adhesive hydrogel that is able to seal AF defects, reduce disc height loss, and partially restore bovine IVD biomechanical function with compressive stiffness close to the intact state (39).…”

Section: Introductionmentioning

confidence: 99%

Effects of Level, Loading Rate, Injury and Repair on Biomechanical Response of Ovine Cervical Intervertebral Discs

et al. 2018

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A need exists for pre-clinical large animal models of the spine to translate biomaterials capable of repairing intervertebral disc (IVD) defects. This study characterized the effects of cervical spinal level, loading rate, injury and repair with genipin-crosslinked fibrin (FibGen) on axial and torsional mechanics in an ovine cervical spine model. Cervical IVDs C2-C7 from nine animals were tested with cyclic tension-compression (- 240 to 100 N) and cyclic torsion (± 2° and ± 4°) tests at three rates (0.1, 1 and 2 Hz) in intact, injured and repaired conditions. Intact IVDs from upper cervical levels (C2-C4) had significantly higher torque range and torsional stiffness and significantly lower axial range of motion (ROM) and tensile compliance than IVDs from lower cervical levels (C5-C7). A tenfold increase in loading rate significantly increased torque range and torsional stiffness 4-8% (depending on amplitude) (p < 0.001). When normalized to intact, FibGen significantly restored torque range (FibGen: 0.96 ± 0.14, Injury: 0.88 ± 0.14, p = 0.03) and axial ROM (FibGen: 1.00 ± 0.05, Injury: 1.04 ± 0.15, p = 0.02) compared to Injury, with a values of 1 indicating full repair. Cervical spinal level must be considered for controlling biomechanical evaluations, and FibGen restored some torsional and axial biomechanical properties to intact levels.

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Section: Introductionmentioning

confidence: 99%

Effects of Level, Loading Rate, Injury and Repair on Biomechanical Response of Ovine Cervical Intervertebral Discs

et al. 2018

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“…Various devices developed from different materials are on the market, and there are some more that are still under study (1,2). The main aims of these smart devices are to restore the disc height and to widen the neural foramen.…”

Section: Discussionmentioning

confidence: 99%

Hydrogel implant causing lumbar radiculopathy: a case report

Tufan¹,

Taş²,

Güzey³

et al. 2017

Bagcilar Medical Bulletin

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Objective: One of the new treatment methods for lumbar degenerative disc disease is percutaneous application of a hydrogel implant into the intervertebral disc. The aim of this method is to increase the disc height, to widen the neural foramen, and to decrease discogenic pain and leg pain caused by root compression. However, there may be serious complications related to intervertebral hydrogel implants that have been increasingly used during the last few years because of their minimally-invasive nature. A case with lumbar root compression due to hydrogel implant is being reported.Case Report: A 61-year-old male was admitted with severe left leg pain due to compression of the left L5 root by a hydrogel implant that had been percutaneously introduced into the L4-5 disc level 6 months ago.On magnetic resonance imaging, a lesion compressing the left L5 root at the L4-5 disc level and mimicking a disc herniation was seen. It was hypointense on T1-weighted and hyperintense on T2-weighted sections. Sonuç: İntervertebral hidrojel implant komşu dokulardan su çekerek şişer. Aslında disk yüksekliğinin artmasını sağlayan asıl mekanizma da budur. Ancak eğer çok fazla şişerse, spinal kanal içine taşıp kök ya da dural kese basısına ve nörolojik bulgulara neden olabilir.

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“…In general, whole disc tissue engineering involves combining cells with biomaterial scaffolds to generate a composite structure with distinct NP and AF regions (Figure ) . Engineered AF tissues have previously been fabricated en bloc from porous materials including polyglycolic acid, demineralized bone matrix gelatin, collagen, and silk fibroin, mimicking basic geometry but omitting microarchitectural detail .…”

Section: Progress In Whole Disc Tissue Engineeringmentioning

confidence: 99%

“…Examples of select tissue‐engineered discs (figures reprinted with permissions from References ), and a listing of the biomaterials used in fabricating the AF and NP regions of each design…”

Section: Progress In Whole Disc Tissue Engineeringmentioning

confidence: 99%

Promise, progress, and problems in whole disc tissue engineering

Gullbrand

Smith

et al. 2018

JOR Spine

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Intervertebral disc degeneration is frequently implicated as a cause of back and neck pain, which are pervasive musculoskeletal complaints in modern society. For the treatment of end stage disc degeneration, replacement of the disc with a viable, tissue-engineered construct that mimics native disc structure and function is a promising alternative to fusion or mechanical arthroplasty techniques. Substantial progress has been made in the field of whole disc tissue engineering over the past decade, with a variety of innovative designs characterized both in vitro and in vivo in animal models. However, significant barriers to clinical translation remain, including construct size, cell source, culture technique, and the identification of appropriate animal models for preclinical evaluation. Here we review the clinical need for disc tissue engineering, the current state of the field, and the outstanding challenges that will need to be addressed by future work in this area. K E Y W O R D Sanimal models, biomaterials, biomechanics, disc degeneration, mesenchymal stem cells | INTRODUCTIONBack and neck pain place a significant social and economic burden on modern society, affecting nearly 1 in 2 individuals annually. In the United States alone, these conditions are associated with an estimated $194 billion in yearly medical costs and lost wages. Back pain is commonly associated with degenerative disc disease, a progressive condition with complex underlying etiology, during which component tissues undergo an array of cellular and structural changes that ultimately compromises biomechanical function.Although the pathological manifestations of disc degeneration are well characterized, the underlying causes and the origins of discogenic pain are still not well understood, impeding the development of effective therapies. Current treatments for disc degeneration do not restore native disc structure and function, and thus exhibit limited long-term efficacy. Tissue engineering offers the promise of generating de novo, living structures that recapitulate the form, function, and biology of healthy host tissues with the potential to treat a variety musculoskeletal disorders, including disc degeneration. Here, we review recent progress in the field of whole disc tissue engineering as well as the barriers that will need to be addressed for the successful clinical translation of engineered discs. | INTERVERTEBRAL DISC STRUCTURE AND MECHANICAL FUNCTIONThe intervertebral discs of the spine are composite structures composed of the central nucleus pulposus (NP), the peripheral annulus fibrosus (AF), and the superior and inferior cartilaginous end plates.The extracellular matrix (ECM) of the NP is composed primarily of proteoglycans and type II collagen; the high proteoglycan content of | INTERVERTEBRAL DISC DEGENERATION AND TREATMENTDegeneration of the intervertebral discs may occur with aging or following injury. While the exact pathophysiology of disc degeneration remains unclear, it is known to involve a progressive cascade of cellular,...

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Biomaterials for intervertebral disc regeneration and repair

Cited by 278 publications

References 132 publications

Effects of Level, Loading Rate, Injury and Repair on Biomechanical Response of Ovine Cervical Intervertebral Discs

Effects of Level, Loading Rate, Injury and Repair on Biomechanical Response of Ovine Cervical Intervertebral Discs

Hydrogel implant causing lumbar radiculopathy: a case report

Promise, progress, and problems in whole disc tissue engineering

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