Science Translational Medicine · 2018 · 120 citations · 46 references
MedicineOrthopaedic SurgeryOrthopedic SurgeryBiomechanicsSpinal BiomechanicsTissue EngineeringImplant BiomechanicsIntervertebral Disc BiomechanicsIntervertebral Disc MechanicsLumbar Spine BiomechanicsTissue IntegrationDisc Adaptation To FunctionDisc Tissue Structure-function RelationshipsIntervertebral DiscsLong-term FunctionMicromechanics Of Disc Tissue
Tissue engineering holds great promise for the treatment of advanced intervertebral disc degeneration. However, assessment of in vivo integration and mechanical function of tissue-engineered disc replacements over the long term, in large animal models, will be necessary to advance clinical translation. To that end, we developed tissue-engineered, endplate-modified disc-like angle ply structures (eDAPS) sized for the rat caudal and goat cervical spines that recapitulate the hierarchical structure of the native disc. Here, we demonstrate functional maturation and integration of these eDAPS in a rat caudal disc replacement model, with compressive mechanical properties reaching native values after 20 weeks in vivo and evidence of functional integration under physiological loads. To further this therapy toward clinical translation, we implanted eDAPS sized for the human cervical disc space in a goat cervical disc replacement model. Our results demonstrate maintenance of eDAPS composition and structure up to 8 weeks in vivo in the goat cervical disc space and maturation of compressive mechanical properties to match native levels. These results demonstrate the translational feasibility of disc replacement with a tissue-engineered construct for the treatment of advanced disc degeneration.
46
Christopher J L Murray, Theo Vos, Rafael Lozano et al. · The Lancet · 2012 · 9K citations
Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration
Christian W. A. Pfirrmann, Alexander Metzdorf, Marco Zanetti et al. · Spine · 2001 · 4K citations
Expenditures and Health Status Among Adults With Back and Neck Problems
Brook I. Martin · JAMA · 2008 · 1.5K citations · Full text