Evaluation of Thiol-Modified Hyaluronan and Elastin-Like Polypeptide Composite Augmentation in Early-Stage Disc Degeneration

Leckie, Ashley; Akens, Margarete K.; Woodhouse, Kimberly A.; Yee, Albert; Whyne, Cari

doi:10.1097/brs.0b013e318266ecea

Cited by 25 publications

(19 citation statements)

References 32 publications

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“…Hydrogel injection has been developed in recent years [11–14]. The hydrogel made of hyaluronic acid and/or collagen-hyaluronan has been used for injection and proven to be effective to restore the range of spine motion and the height of intervertebral space [13–15]. As one of the most important functions of the intervertebral disc, cushion and distribution of compression load (shock absorbing function), however, has been overlooked in most current studies.…”

Section: Introductionmentioning

confidence: 99%

Shock Absorbing Function Study on Denucleated Intervertebral Disc with or without Hydrogel Injection through Static and Dynamic Biomechanical Tests In Vitro

Zhou

Gao

Wei

et al. 2014

BioMed Research International

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Hydrogel injection has been recently proposed as a novel therapy for disc degenerative diseases, with the potential to restore the spine motion and the intervertebral disc height. However, it remains unknown whether the new technique could also maintain the shock absorbing property of the treated intervertebral disc. In this study, 18 porcine lumbar bone-disc-bone specimens were collected and randomly divided into three groups: the normal with intact intervertebral discs, the mimic for the injection of disulfide cross-linked hyaluronan hydrogels following discectomy, and the control disc with discectomy only. In the static compression test, specimens in the mimic group exhibited displacements similar to those in the normal discs, whereas the control group showed a significantly larger displacement range in the first two steps (P < 0.05). With the frequency increasing, all specimens generally displayed an increasing storage modulus, decreasing loss modulus, and tanδ. At any frequency point, the control group exhibited the largest value in all the three parameters among three groups while the normal group was the lowest, with the mimic group being mostly close to the normal group. Therefore, the hydrogel injection into the intervertebral discs greatly restored their shock absorbing function, suggesting that the technique could serve as an effective approach to maintaining biomechanical properties of the degenerative intervertebral disc.

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Section: Introductionmentioning

confidence: 99%

Shock Absorbing Function Study on Denucleated Intervertebral Disc with or without Hydrogel Injection through Static and Dynamic Biomechanical Tests In Vitro

Zhou

Gao

Wei

et al. 2014

BioMed Research International

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“…Bunlardan bazıları; NuCore ® (protein polimer hydrogel) (Spine Wave, Inc., Shelton, CT, USA), HA-pNIPAM (hyaluronan greftlenmiş poly (N-isopropylacrylamide hydrogel) (Laboratuvar ortamında oluşturuluyor) domuz nucleus pulposus temelli hyaluronic acid (Laboratuvar ortamında oluşturuluyor), Hydrogel/disc hücre solution (20 mg/ml, Visiol, TRB Chemedica AG, Munchen, Germany), NOVOCARTTM Disc plus (otolog disk kondrosit transplantasyonu için bir otolog hücre içeriği) (Synlab MVZ, LeinfeldenEchterdingen, Germany), Polyethileneglycol-Laminin-111 (AR-G2, TA Instruments, New Castle, DE), İnsan göbek kordonu dokusu (Roche Diagnostics, Indianapolis, IN, USA), Photocrosslinkable hyaluronik asit hidrojelleri içinde nükleus pulposus hücreleri (Sigma Aldrich; St. Louis, MO, USA), Platelet-zengin plazma (Laboratuvar ortamında uygulanıyor), Tiyolle modifiye edilmiş hyaluronan ve elastin-benzeri polipeptit (Laboratuvar ortamında uygulanıyor), İnsan mezenşimal stem hücreleri (Laboratuvar ortamında uygulanıyor), Novel poly N-acetyl glucosamine (Laboratuvar ortamında uygulanıyor), Hydrogel (HPAN) (GelstixTM)'dir. 4,9,[19][20][21][22][23][24][25][26][27][28][29] Hidrogel HPAN GelStix TM implantların spinal uygulanması için yapılan birçok in vivo ve in vitro çalışma göstermiştir ki hidrojel implantlar; DDH prognozunu pozitif olarak etkilemiş, disk içindeki suyun miktarını, disk içi P H 'yı, lomber ROM açı-larını artırmış ve güvenli şekilde uygulanabilmiş-tir. 4,7,9,10,30-32 Bacak VAS değerleri "root"lara olan basının azalması sonucu düşerken bel VAS değer-leri ise disk içi P H 'nın yükselmesine, su içeriğinin artmasına ve uzun dönemde inflamasyonun azalmasına bağlı olabilmektedir.…”

Section: Bulgularunclassified

Patients with Lumbar Black Disk Who Applied Intradiscal GelStixTM that Retrospective Analysis of the Effects to the Clinical Symptoms of the Patient Referred to Algology Policlinic in Bağcılar Training and Research Hospital

Yektaş¹

2017

Turkiye Klinikleri J Anest Reanim

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Ö ÖZ ZE ET T A Am ma aç ç: : Hidrojel, içsel hidrofilikliğinden dolayı kendi ağırlığına göre daha geniş miktarda suyu absorbe edebilir. Bu eğilimin sonucu olarak suyun büyük miktarını içine çekebilir. Hidrojel düşük volümde, dehidrate durumda ve kollapse biçimde vücuda implante edilebilir ve in vivo vücut sıvısının tam absorpsiyonuyla genişledikten sonra çok daha büyük volüm içeren farklı bir şekil aldığı farz edilir. Çoğu hidrojeller değişik kimyasallar temel alınarak geliştirilebilir, fakat hidrolize poliakrilnitril (HPAN) çok geniş bir şekilde çalışılmış ve kontakt lensler, ilaç salınım sistemleri, jinekolojik ve ortopedik implantlar da kullanılmıştır. Siyah diski olan hastalarda, intradiskal GelSitix TM (HPAN) uygulamasının kısa ve uzun dönem disk yükseklikleri, vizüel analog skala (VAS) ve kısa form-36 değerlerine etkisini incelemektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Klinik ve manyetik rezonans görüntüleme (MRG) bulgularıyla siyah disk tanısı alan 22 hastaya 25 adet GelStix TM uygulandı. Tüm veriler retrospektif olarak incelendi. GelStix TM intradiskal girişim sonrası uygulandı. İntradiskal girişim floroskopi eşliğinde yapıldı. Lateral görünümde floroskopiyle cambın üçgeni belirginleşti-rildi. Cambın üçgeninin tepesinden iğneyle disk içine girildi. A-P görünümde iğnenin pozisyonu doğrulandı. Hastaların işlem öncesi ve sonrası disk yükseklikleri, VAS ve kısa form-36 değerleri istatistiksel olarak karşılaştırıldı. B Bu ul lg gu ul la ar r: : Hastaların işlem öncesi MRG siyah disk yükseklikleri, işlem sonrası disk yüksekliklerinden istatistiksel olarak anlamlı derecede düşük idi. İşlem öncesi VAS değerleri, işlem sonrası 1. saat 6, 12 ve 24. ay VAS değerlerine göre istatistiksel olarak anlamlı yüksek idi. S So on nu uç ç: : GelStix TM siyah disk yüksekliklerini artırmakta, hastaların bel ve bacak VAS değerlerini düşürmektedir.A An na ah ht ta ar r K Ke el li im me el le er r: : Nörodejeneratif hastalıklar; vertebralar arası disk A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Hydrogels are able to absorb large quantities of water relative to their initial weight because of their intrinsic hydrophilicity. As a result of this propensity to imbibe large quantities of water, the material can be implanted into the bady in a collapsed, low volume, dehydrated state and then expanded in vivo through absorbtion of bady fluids to assume a different shabe comprising a much greater volume. Although many hydrogels have been developed based on various chemistries, hydrolyzed polyacrylonitrile (HPAN) has been extensively studied and used in the formulation of contact lenses, drug delivery, gynaecologial and orthopaedic implants. Patients with black disc who applied intradiscal GelStix TM which to examine the effect to disc height, value-added service (VAS) score, short form-36 score in the short and long term. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 25 Gelsitixs TM appled to 22 patients with clinic and magnetic resonance imaging (MRI) finding. All the data were analyzed retr...

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“…The concept of placing a biologically active agent in the intervertebral disc to help regenerate or stabilize the degenerative processes of aging has been theorized for decades. [163058]…”

Section: Spinal Biologicsmentioning

confidence: 99%

The future of spine surgery: New horizons in the treatment of spinal disorders

Kazemi

Crew²,

Tredway³

2013

Surg Neurol Int

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Background and Methods:As with any evolving surgical discipline, it is difficult to predict the future of the practice and science of spine surgery. In the last decade, there have been dramatic developments in both the techniques as well as the tools employed in the delivery of better outcomes to patients undergoing such surgery. In this article, we explore four specific areas in spine surgery: namely the role of minimally invasive spine surgery; motion preservation; robotic-aided surgery and neuro-navigation; and the use of biological substances to reduce the number of traditional and revision spine surgeries.Results:Minimally invasive spine surgery has flourished in the last decade with an increasing amount of surgeries being performed for a wide variety of degenerative, traumatic, and neoplastic processes. Particular progress in the development of a direct lateral approach as well as improvement of tubular retractors has been achieved. Improvements in motion preservation techniques have led to a significant number of patients achieving arthroplasty where fusion was the only option previously. Important caveats to the indications for arthroplasty are discussed. Both robotics and neuro-navigation have become further refined as tools to assist in spine surgery and have been demonstrated to increase accuracy in spinal instrumentation placement. There has much debate and refinement in the use of biologically active agents to aid and augment function in spine surgery. Biological agents targeted to the intervertebral disc space could increase function and halt degeneration in this anatomical region.Conclusions:Great improvements have been achieved in developing better techniques and tools in spine surgery. It is envisaged that progress in the four focus areas discussed will lead to better outcomes and reduced burdens on the future of both our patients and the health care system.

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Evaluation of Thiol-Modified Hyaluronan and Elastin-Like Polypeptide Composite Augmentation in Early-Stage Disc Degeneration

Cited by 25 publications

References 32 publications

Shock Absorbing Function Study on Denucleated Intervertebral Disc with or without Hydrogel Injection through Static and Dynamic Biomechanical Tests In Vitro

Shock Absorbing Function Study on Denucleated Intervertebral Disc with or without Hydrogel Injection through Static and Dynamic Biomechanical Tests In Vitro

Patients with Lumbar Black Disk Who Applied Intradiscal GelStixTM that Retrospective Analysis of the Effects to the Clinical Symptoms of the Patient Referred to Algology Policlinic in Bağcılar Training and Research Hospital

The future of spine surgery: New horizons in the treatment of spinal disorders

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