The Effect of Hydrostatic Pressure on Intervertebral Disc Metabolism

Hutton, William; Elmer, William A.; Boden, Scott D.; Hyon, Steve; Toribatake, Yasumitsu; Tomita, Katsuro; Hair, Gregory A.

doi:10.1097/00007632-199908010-00002

Cited by 163 publications

(99 citation statements)

References 30 publications

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“…The application of a constant hydrostatic pressure has been shown to affect disc cell metabolism in a magnitude-and durationdependent manner. A constant hydrostatic pressure of 0.3-1 MPa increased matrix synthesis in bovine caudal disc tissue, dog IVD cells in alginate and even human pathological disc tissue but hydrostatic pressure higher than 3 MPa was found to induce a catabolic response of the disc cells [36,42,43,46,65].…”

Section: In Vitro Organ Culturementioning

confidence: 94%

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The effects of dynamic loading on the intervertebral disc

2011

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Loading is important to maintain the balance of matrix turnover in the intervertebral disc (IVD). Daily cyclic diurnal assists in the transport of large soluble factors across the IVD and its surrounding circulation and applies direct and indirect stimulus to disc cells. Acute mechanical injury and accumulated overloading, however, could induce disc degeneration. Recently, there is more information available on how cyclic loading, especially axial compression and hydrostatic pressure, affects IVD cell biology. This review summarises recent studies on the response of the IVD and stem cells to applied cyclic compression and hydrostatic pressure. These studies investigate the possible role of loading in the initiation and progression of disc degeneration as well as quantifying a physiological loading condition for the study of disc degeneration biological therapy. Subsequently, a possible physiological/beneficial loading range is proposed. This physiological/beneficial loading could provide insight into how to design loading regimes in specific system for the testing of various biological therapies such as cell therapy, chemical therapy or tissue engineering constructs to achieve a better final outcome. In addition, the parameter space of 'physiological' loading may also be an important factor for the differentiation of stem cells towards most ideally 'discogenic' cells for tissue engineering purpose.

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Section: In Vitro Organ Culturementioning

confidence: 94%

“…The influence of static hydrostatic pressure has been studied on isolated human and animal disc cells [42,43,65] (Table 3). The application of a constant hydrostatic pressure has been shown to affect disc cell metabolism in a magnitude-and durationdependent manner.…”

Section: In Vitro Organ Culturementioning

confidence: 99%

The effects of dynamic loading on the intervertebral disc

2011

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“…These high compressive loads, causing increased compressive stress, may at the very least produce pain, and at the worst initiate or contribute to a degenerative remodeling response in the posterior IVD region. Indeed, a relationship between mechanical stress in the IVD and cell metabolism has been previously identified [15]. Recent clinical findings indicate that abnormal sagittal balance (anterior translation of 25 mm or more for C7-S1) is associated with a greater incidence of degenerative disc disease [26].…”

Section: Discussionmentioning

confidence: 99%

Anterior thoracic posture increases thoracolumbar disc loading

Harrison¹,

Colloca

Harrison

et al. 2004

Eur Spine J

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In the absence of external forces, the largest contributor to intervertebral disc (IVD) loads and stresses is trunk muscular activity. The relationship between trunk posture, spine geometry, extensor muscle activity, and the loads and stresses acting on the IVD is not well understood. The objective of this study was to characterize changes in thoracolumbar disc loads and extensor muscle forces following anterior translation of the thoracic spine in the upright posture. Vertebral body geometries (C2 to S1) and the location of the femoral head and acetabulum centroids were obtained by digitizing lateral, full-spine radiographs of 13 men and five women volunteers without previous history of back pain. Two standing, lateral, fullspine radiographic views were obtained for each subject: a neutralposture lateral radiograph and a radiograph during anterior translation of the thorax relative to the pelvis (while keeping T1 aligned over T12). Extensor muscle loads, and compression and shear stresses acting on the IVDs, were calculated for each posture using a previously validated biomechanical model. Comparing vertebral centroids for the neutral posture to the anterior posture, subjects were able to anterior translate +101.5 mm±33.0 mm (C7-hip axis), +81.5 mm±39.2 mm (C7-S1) (vertebral centroid of C7 compared with a vertical line through the vertebral centroid of S1), and +58.9 mm±19.1 mm (T12-S1). In the anterior translated posture, disc loads and stresses were significantly increased for all levels below T9. Increases in IVD compressive loads and shear loads, and the corresponding stresses, were most marked at the L5-S1 level and L3-L4 level, respectively. The extensor muscle loads required to maintain static equilibrium in the upright posture increased from 147.2 N (mean, neutral posture) to 667.1 N (mean, translated posture) at L5-S1. Compressive loads on the anterior and posterior L5-S1 disc nearly doubled in the anterior translated posture. Anterior translation of the thorax resulted in significantly increased loads and stresses acting on the thoracolumbar spine. This posture is common in lumbar spinal disorders and could contribute to lumbar disc pathologies, progression of L5-S1 spondylolisthesis deformities, and poor outcomes after lumbar spine surgery. In conclusion, anterior trunk translation in the standing subject increases extensor muscle activity and loads and stresses acting on the intervertebral disc in the lower thoracic and lumbar regions.

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“…Previous studies have examined the effects of hydrostatic pressure on cells of the annulus fibrosus in 3D hydrogels, citing decreases in anabolic gene expression and collagen production in comparison to controls 11,12,24 . While quantitative ELISA data (normalized to DNA) showed no overall effect of cell type on collagen production (COL I: p = 0.7733, COL II: p = 0.8929), OA-seeded scaffolds displayed more ECM accumulation ( Figure 7).…”

Section: As Shown Inmentioning

confidence: 99%

Hydrostatic Pressure Differentially Regulates Outer and Inner Annulus Fibrosus Cell Matrix Production in 3D Scaffolds

Reza

Nicoll

2007

Ann Biomed Eng

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Mechanical stimulation may be used to enhance the development of engineered constructs for the replacement of load bearing tissues, such as the intervertebral disc. This study examined the effects of dynamic hydrostatic pressure (HP) on outer and inner annulus (OA, IA) fibrosus cells seeded on fibrous poly(glycolic acid)-poly(L-lactic acid) scaffolds. Constructs were pressurized (5 MPa, 0.5 Hz) for four hours/day from day 3 to day 14 of culture and analyzed using ELISAs and immunohistochemistry (IHC) to assess extracellular matrix (ECM) production. Both cell types were viable, with OA cells exhibiting more infiltration into the scaffold, which was enhanced by HP. ELISA analyses revealed that HP had no effect on type I collagen production while a significant increase in type II collagen (COL II) was measured in pressurized OA constructs compared to day 14 unloaded controls. Both OA and IA dynamically loaded scaffolds exhibited more uniform COL II elaboration as shown by IHC analyses, which was most pronounced in OA-seeded scaffolds. Overall, HP resulted in enhanced ECM elaboration and organization by OA-seeded constructs, while IA-seeded scaffolds were less responsive. As such, hydrostatic pressurization may be beneficial in annulus fibrosus tissue engineering when applied in concert with an appropriate cell source and scaffold material. scaffolds. Constructs were pressurized (5 MPa, 0.5 Hz) for four hours/day from day 3 to day 14 of culture and analyzed using ELISAs and immunohistochemistry (IHC) to assess extracellular matrix (ECM) production. Both cell types were viable, with OA cells exhibiting more infiltration into the scaffold, which was enhanced by HP. ELISA analyses revealed that HP had no effect on type I collagen production while a significant increase in type II collagen (COL II) was measured in pressurized OA constructs compared to day 14 unloaded controls. Both OA and IA dynamically loaded scaffolds exhibited more uniform COL II elaboration as shown by IHC analyses, which was most pronounced in OA-seeded scaffolds. Overall, HP resulted in enhanced ECM elaboration and organization by OA-seeded constructs, while IA-seeded scaffolds were less responsive. As such, hydrostatic pressurization may be beneficial in annulus fibrosus tissue engineering when applied in concert with an appropriate cell source and scaffold material.

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The Effect of Hydrostatic Pressure on Intervertebral Disc Metabolism

Abstract: Hydrostatic pressure directly affects the synthesis of collagen and proteoglycan by the intervertebral disc cells.

Cited by 163 publications

References 30 publications

The effects of dynamic loading on the intervertebral disc

The effects of dynamic loading on the intervertebral disc

Anterior thoracic posture increases thoracolumbar disc loading

Hydrostatic Pressure Differentially Regulates Outer and Inner Annulus Fibrosus Cell Matrix Production in 3D Scaffolds

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