The role of the nucleus pulposus in neutral zone human lumbar intervertebral disc mechanics

Cannella, Marco; Arthur, Amy; Allen, Shanee; Keane, Michael; Joshi, Abhijeet; Vresilovic, Edward J.; Marcolongo, Michele

doi:10.1016/j.jbiomech.2008.04.037

Cited by 54 publications

(62 citation statements)

References 33 publications

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“…55 , 56 Furthermore, researchers have studied the instability of the spine and have reported that the nucleus pulposus plays a dominant role through the NZ. 57 Although the increasing trend in the NZ reported in this study was not signifi cant, these increases may also be related to the early degenerative changes in the IVD allograft after transplantation. 24 , 58 The functional spinal units are joined by 3 articulations known as the "triple joint complex."…”

Section: Discussioncontrasting

confidence: 50%

The Effect of Remodeling on the Kinematics of the Malpositioned Disc Allograft Transplantation

Lam

Xiao

Ruan

et al. 2012

Spine

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Study Design. A postoperative biomechanical study.Objective. This study aimed to assess whether the mal-alignment of the intervertebral disc (IVD) allograft during transplantation would negatively affect the biomechanics of the spinal segment. Summary of Background Data. Studies of human IVD allograft transplantation have observed remodeling of the allograft implant, suggesting that the remodeling of the allograft may be able to restore the natural mechanics of the IVD. Methods. Eighteen male goats (age: 6-12 months; weight: 25-30 kg) were randomly assigned into control (n = 5), aligned (n = 5), or malpositioned (n = 5) groups. Transplantation of a size-matched cryopreserved IVD allograft was performed in the lumbar region (L4-L5) after disc excision. In the aligned group, the IVD allografts were placed aligned and fl ush with the anterior vertebral margin. In the malpositioned group, the allografts were placed proud anteriorly by 25% of the anterior-posterior diameter of the allograft. The lumbar spines were harvested at 6 months after transplantation. Three-dimensional kinematic assessment of the lumbar spines was performed using an MTS testing machine and an optoelectronic camera system. The range of motion, neutral zone, and instantaneous axis of rotation were calculated. Results. No signifi cant difference in range of motion was noted between the groups in fl exion, axial rotation, and lateral bending. Signifi cance was noted with extension range of motion as detected

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Section: Discussioncontrasting

confidence: 50%

The Effect of Remodeling on the Kinematics of the Malpositioned Disc Allograft Transplantation

Lam

Xiao

Ruan

et al. 2012

Spine

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“…Interestingly, the graded decrease in parameter D, which represents a diminishing role of swelling pressure of the NP, is consistent with needle size, in agreement with previous studies on partial and full nucleotomy of ovine 69 and human discs. 70 The capability for puncture wounds to collapse may explain why needle tracks could not be found in 22-and 26-g punctured discs at 1 week in vivo. Perhaps closely apposed tissue is more readily repaired than larger defects containing extruded NP.…”

Section: Discussionmentioning

confidence: 99%

Degenerative Anular Changes Induced by Puncture Are Associated With Insufficiency of Disc Biomechanical Function

Hsieh¹,

Hwang²,

Ryan³

et al. 2009

Spine

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“…In a separate study, we determined that by controlling the nucleus replacement material implantation pressure and volume, compressive, bending, and torsional stability were restored to the disk [25]. We also found that the compressive biomechanics were predictive of the bending and torsional biomechanics [25,26]. However, we have not yet examined the role of the nucleus cavity size on the ability of the nucleus replacement to restore mechanics.…”

Section: Introductionmentioning

confidence: 98%

Nucleus Implantation: The Biomechanics of Augmentation Versus Replacement With Varying Degrees of Nucleotomy

Cannella

Isaacs

Allen

et al. 2014

Journal of Biomechanical Engineering

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Nucleus pulposus replacement and augmentation has been proposed to restore disk mechanics in early stages of degeneration with the option of providing a minimally invasive procedure for pain relief to patients with an earlier stage of degeneration. The goal of this paper is to examine compressive stability of the intervertebral disk after either partial nucleus replacement or nuclear augmentation in the absence of denucleation. Thirteen human cadaver lumbar anterior column units were used to study the effects of denucleation and augmentation on the compressive mechanical behavior of the human intervertebral disk. Testing was performed in axial compression after incremental steps of partial denucleation and subsequent implantation of a synthetic hydrogel nucleus replacement. In a separate set of experiments, the disks were not denucleated but augmented with the same synthetic hydrogel nucleus replacement. Neutral zone, range of motion, and stiffness were measured. The results showed that compressive stabilization of the disk can be re-established with nucleus replacement even for partial denucleation. Augmentation of the disk resulted in an increase in disk height and intradiskal pressure that were linearly related to the volume of polymer implanted. Intervertebral disk instability, evidenced by increased neutral zone and ranges of motion, associated with degeneration can be restored by volume filling of the nucleus pulposus using the hydrogel device presented here.

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The role of the nucleus pulposus in neutral zone human lumbar intervertebral disc mechanics

Cited by 54 publications

References 33 publications

The Effect of Remodeling on the Kinematics of the Malpositioned Disc Allograft Transplantation

The Effect of Remodeling on the Kinematics of the Malpositioned Disc Allograft Transplantation

Degenerative Anular Changes Induced by Puncture Are Associated With Insufficiency of Disc Biomechanical Function

Nucleus Implantation: The Biomechanics of Augmentation Versus Replacement With Varying Degrees of Nucleotomy

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