Immune Response Inhibition by Irrigating Subchondral Bone With Cytotoxic Agents

Rodrigo, Juan J.; Heiden, Eric A.; Hegyes, M.; Sharkey, Neil A.

doi:10.1097/00003086-199605000-00012

Cited by 23 publications

(14 citation statements)

References 23 publications

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“…Studies have been performed on various animal models to investigate the performance of disc unit transplantation as a biological treatment for alleviating pain and preserving motion of severely degenerated discs. Feasibility of disc grafting has been studied using disc-vertebral-disc units , IVD autografts (Frick et al, 1994), fresh IVD allografts (Luk et al, 1997) and recently, cryopreserved IVD allografts (Katsuura and Hukuda, 1994;Luk et al, 2003;Matsuzaki et al, 1996;Ruan et al, 2007). Cryopreserved IVD allograft transplantation is more practical in the clinical setting than fresh allografts because of the limited allograft availability and the need for size matching.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, establishing an IVD bank with various disc sizes is essential for the clinical application of IVD allograft transplantation (Luk and Ruan, 2008). Tissue allografts that underwent cryopreservation are proposed to have reduced immunogenicity (Rodrigo et al, 1996). However, allograft preservation may compromise the disc cell viability as cells could be damaged due to the freezing and thawing procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Both authors suggested that penetration of the CPA into the disc tissue, especially into the NP, is the major hurdle for successful disc graft cryopreservation. Ruan et al used a similar approach for cryopreserving the human cervical disc allograft in the recent clinical trial, and the allografts were transplanted into 5 patients with cervical disc herniation (Ruan et al, 2007). A five-year clinical follow-up was performed with serial MRI and static and dynamic radiographs to monitor the stability and mobility of the graft segment.…”

Section: Discussionmentioning

confidence: 99%

“…This may be achieved in the future through tissue engineered solutions (Kandel et al, 2008), or by allogeneic human disc transplantation (Luk et al 1997). The latter has been shown in animal studies and pilot clinical trials to be feasible (Frick et al, 1994;Katsuura and Hukuda, 1994;Luk et al, 1997;Luk et al, 2003;Luk and Ruan, 2008;Matsuzaki et al, 1996;Ruan et al, 2007). Five years follow-up results in the human clinical trial of whole IVD replacement using the cryopreserved disc allograft has shown encouraging potential for the preservation of spinal stability and segmental motion (Luk and Ruan, 2008;Ruan et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…The latter has been shown in animal studies and pilot clinical trials to be feasible (Frick et al, 1994;Katsuura and Hukuda, 1994;Luk et al, 1997;Luk et al, 2003;Luk and Ruan, 2008;Matsuzaki et al, 1996;Ruan et al, 2007). Five years follow-up results in the human clinical trial of whole IVD replacement using the cryopreserved disc allograft has shown encouraging potential for the preservation of spinal stability and segmental motion (Luk and Ruan, 2008;Ruan et al, 2007). However, the transplanted disc progressively degenerates, and this is thought to be associated with suboptimal cell activity from cryo-damage, hence compromising the ability to maintain fully functional integrity of the IVD in the long term (Katsuura and Hukuda, 1994;Matsuzaki et al, 1996;Luk et al, 1997;Luk et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Minimizing cryopreservation-induced loss of disc cell activity for storage of whole intervertebral discs

Chan

Lam²,

Leung³

et al. 2010

eCM

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Severe intervertebral disc (IVD) degeneration often requires disc excision and spinal fusion, which leads to loss of spinal segment mobility. Implantation of an allograft disc or tissue engineered disc construct emerges as an alternative to artificial disc replacement for preserving the motion of the degenerated level. Establishment of a bank of cadaveric or engineered cryopreserved discs enables size matching, and facilitates clinical management. However, there is a lack of understanding of the behaviour of disc cells during cryopreservation, as well as how to maximize their survival, such that disc graft properties can be preserved. Here, we report on the effect of alterations in cooling rates, cryoprotective agents (CPAs), and duration of precryopreservation incubation in CPA on cellular activity in whole porcine lumbar discs. Our results indicated that cooling rates of -0.3°C/min and -0.5°C /min resulted in the least loss of metabolic activity in nucleus pulposus (NP) and annulus fibrosus (AF) respectively, while metabolic activity is best maintained by using a combination of 10% dimethylsulphoxide (DMSO) and 10% propylene-glycol (PG) as CPA. By the use of such parameters, metabolic activity of the NP and the AF cells could be maintained at 70% and 45%, respectively, of that of the fresh tissue. Mechanical testing and histological evaluation showed no significant differences in mechanical properties or alterations in disc structure compared to fresh discs. Despite the limitations of the animal model, our findings provide a framework for establishing an applicable cryopreservation protocol for human disc allografts or tissue-engineered disc constructs.

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