The Influence of Axial Compression on the Cellular and Mechanical Function of Spinal Tissues; Emphasis on The Nucleus Pulposus and Annulus Fibrosus

2021 ◽  
Author(s):  
John McMorran ◽  
Diane Gregory
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Axial Compression ◽  
Disc Degeneration ◽  
Annulus Fibrosus ◽  
Intervertebral Disc Degeneration ◽  
Chronic Back Pain ◽  
Physiological State ◽  
Movement Pattern ◽  
Mechanical Function

Abstract In light of the correlation between chronic back pain and intervertebral disc degeneration, this literature review seeks to illustrate the importance of the hydraulic response across the nucleus pulposus- annulus fibrosus interface, by synthesizing current information regarding injurious biomechanics of the spine, stemming from axial compression. Damage to vertebrae, endplates, the nucleus pulposus, and the annulus fibrosus, can all arise from axial compression, depending on the segment's posture, the manner in which it is loaded, and the physiological state of tissue. Therefore, this movement pattern was selected to illustrate the importance of the bracing effect of a pressurized nucleus pulposus on the annulus fibrosus, and how injuries interrupting support to the annulus fibrosus may contribute to intervertebral disc degeneration.

Combined nucleus pulposus augmentation and annulus fibrosus repair prevents acute intervertebral disc degeneration after discectomy

2020 ◽  
Vol 12 (534) ◽  
pp. eaay2380 ◽  
Author(s):  
Stephen R. Sloan ◽  
Christoph Wipplinger ◽  
Sertaç Kirnaz ◽  
Rodrigo Navarro-Ramirez ◽  
Franziska Schmidt ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Disc Degeneration ◽  
Annulus Fibrosus ◽  
Intervertebral Disc Degeneration ◽  
Early Stage ◽  
Mechanical Function ◽  
Therapy Targets ◽  
Hyaluronic Acid Injection ◽  
Combined Strategy

Tissue-engineered approaches for the treatment of early-stage intervertebral disc degeneration have shown promise in preclinical studies. However, none of these therapies has been approved for clinical use, in part because each therapy targets only one aspect of the intervertebral disc’s composite structure. At present, there is no reliable method to prevent intervertebral disc degeneration after herniation and subsequent discectomy. Here, we demonstrate the prevention of degeneration and maintenance of mechanical function in the ovine lumbar spine after discectomy by combining strategies for nucleus pulposus augmentation using hyaluronic acid injection and repair of the annulus fibrosus using a photocrosslinked collagen patch. This combined approach healed annulus fibrosus defects, restored nucleus pulposus hydration, and maintained native torsional and compressive stiffness up to 6 weeks after injury. These data demonstrate the necessity of a combined strategy for arresting intervertebral disc degeneration and support further translation of combinatorial interventions to treat herniations in the human spine.

scholarly journals Application study of 3D LAVA-Flex on lumbar intervertebral disc degeneration

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiefang Liu ◽  
Yonghao Wang ◽  
Zhengyang Xu ◽  
Tao Wu ◽  
Xiao Zang ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Disc Degeneration ◽  
Annulus Fibrosus ◽  
Intervertebral Disc Degeneration ◽  
Virtual Endoscopy ◽  
Intervertebral Space ◽  
Lumbar Intervertebral Disc ◽  
Component Structure ◽  
Pfirrmann Grade

Abstract Background Degeneration of the intervertebral discs are very common diseases, indicating the specific or malignant changes in intervertebral disc component, structure and function. Imaging examination is currently used to evaluate the severity of lumbar intervertebral disc degeneration. This study was designed to investigate the diagnostic value of 3D LAVA-Flex in lumbar intervertebral disc degeneration. Material and methods Sagittal 3D LAVA-Flex and T2WI scans were performed in 45 patients with lumbar intervertebral disc degeneration. On T2WI, the degenerated intervertebral disc in every patient was evaluated using Pfirrmann grade. Then, the patients were re-evaluated using 3D LAVA-Flex with considerations of the distinction of nucleus pulposus and annulus fibrosus, hypointense signal of intervertebral disc and height of intervertebral disc. The evaluation results were compared between 3D LAVA-Flex and T2WI. Virtual endoscopy was also performed to evaluate the degenerated intervertebral disc. Results The intermediate–intense signal of nucleus pulposus and complete ring-shaped hyperintense signal of annulus fibrosus were found and the distinction of nucleus pulposus and annulus fibrosus was clear in the normal intervertebral disc on 3D LAVA-Flex. The incidence of linear hypointensity of narrowed intervertebral space (65/91) was higher than that of normal intervertebral space (4/134) (P = 0.000). A good consistency was shown between the LAVA-Flex grade and T2WI-based Pfirrmann grade. Virtual endoscopy based on 3D LAVA-Flex could help clearly show the anatomic relationship between the degenerated disc and intervertebral foramen. Conclusions 3D LAVA-Flex and T2WI show similar efficacy in evaluating lumbar intervertebral disc degeneration. 3D LAVA-Flex-based virtual endoscopy possesses great potential in the study of intervertebral disc abnormalities.

scholarly journals Intervertebral Disc Degeneration in Warmblood Horses: Morphology, Grading, and Distribution of Lesions

2018 ◽  
Vol 55 (3) ◽  
pp. 442-452 ◽  
Author(s):  
Wilhelmina Bergmann ◽  
Niklas Bergknut ◽  
Stefanie Veraa ◽  
Andrea Gröne ◽  
Hans Vernooij ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Disc Degeneration ◽  
Clinical Relevance ◽  
Annulus Fibrosus ◽  
Intervertebral Disc Degeneration ◽  
Thoracolumbar Spine ◽  
Intervertebral Discs ◽  
Vertebral Bone ◽  
Cleft Formation

Equine intervertebral disc degeneration is thought to be rare and of limited clinical relevance, although research is lacking. To objectively assess pathological changes of the equine intervertebral disc and their clinical relevance, description of the normal morphology and a practical, biologically credible grading scheme are needed. The objectives of this study are to describe the gross and histological appearance of the equine intervertebral discs and to propose a grading scheme for macroscopic degeneration. Spinal units from 33 warmblood horses were grossly analyzed and scored. Of the 286 intervertebral discs analyzed, 107 (37%) were assigned grade 1 and grade 2 (considered normal) and were analyzed histologically. A nucleus pulposus and an annulus fibrosus could be identified macroscopically and histologically. Histologically, the nucleus pulposus was composed of a cartilaginous matrix and the annulus fibrosus of parallel collagenous bands. A transition zone was also histologically visible. Intra- and inter-observer reliability scores were high for all observers. Higher grades were associated with greater age. Gross changes associated with equine intervertebral disc degeneration (grades 3–5)—that is, yellow discoloration, cleft formation (tearing), and changes in consistency of the nucleus pulposus—were largely similar to those in humans and dogs and were most prevalent in the caudal cervical spine. Equine intervertebral disc degeneration was not associated with osteophyte formation. Changes of the vertebral bone were most common in the thoracolumbar spine but were not correlated with higher grades of intervertebral disc degeneration. Thus, changes of the vertebral bone should be excluded from grading for equine intervertebral disc degeneration.

scholarly journals Disordered Mechanical Stress and Tissue Engineering Therapies in Intervertebral Disc Degeneration

Polymers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1151 ◽  
Author(s):  
Runze Zhao ◽  
Wanqian Liu ◽  
Tingting Xia ◽  
Li Yang
Keyword(s):  
Tissue Engineering ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Mechanical Stress ◽  
Nucleus Pulposus ◽  
Disc Degeneration ◽  
Annulus Fibrosus ◽  
Intervertebral Disc Degeneration ◽  
Intervertebral Discs ◽  
Body Motion

Low back pain (LBP), commonly induced by intervertebral disc degeneration, is a lumbar disease with worldwide prevalence. However, the mechanism of degeneration remains unclear. The intervertebral disc is a nonvascular organ consisting of three components: Nucleus pulposus, annulus fibrosus, and endplate cartilages. The disc is structured to support our body motion and endure persistent external mechanical pressure. Thus, there is a close connection between force and intervertebral discs in LBP. It is well established that with aging, disordered mechanical stress profoundly influences the fate of nucleus pulposus and the alignment of collagen fibers in the annulus fibrosus. These support a new understanding that disordered mechanical stress plays an important role in the degeneration of the intervertebral discs. Tissue-engineered regenerative and reparative therapies are being developed for relieving disc degeneration and symptoms of lower back pain. In this paper, we will review the current literature available on the role of disordered mechanical stress in intervertebral disc degeneration, and evaluate the existing tissue engineering treatment strategies of the current therapies.

scholarly journals Expression of miR-195 and its target gene Bcl-2 in human intervertebral disc degeneration and their effects on nucleus pulposus cell apoptosis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xue-Lin Lin ◽  
Zhao-Yun Zheng ◽  
Qing-Shan Zhang ◽  
Zhen Zhang ◽  
You-Zhi An
Keyword(s):  
Cell Proliferation ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Disc Degeneration ◽  
Rat Model ◽  
Cell Apoptosis ◽  
Intervertebral Disc Degeneration ◽  
Target Gene ◽  
Blank Group ◽  
Tnf Α

Abstract Objective To investigate the expression of miR-195 and its target gene Bcl-2 in intervertebral disc degeneration (IVDD) and its effect on nucleus pulposus (NP) cell apoptosis. Methods The expressions of miR-195 and Bcl-2 in NP tissues of IVDD patients were quantified by qRT-PCR and western blotting, respectively. NP cells were divided into blank group, TNF-α group, TNF-α + miR-NC group, TNF-α + siBcl-2 group, and TNF-α + miR-195 inhibitors + siBcl-2 group. Cell proliferation was detected by MTT assay, cell apoptosis evaluated by flow cytometry, and mitochondrial membrane potential (MMP) tested by JC-1 staining. Moreover, the function of miR-195 on IVDD in vivo was investigated using a puncture-induced IVDD rat model. Results IVDD patients had significantly increased miR-195 expression and decreased Bcl-2 protein expression in NP tissues. The expression of miR-195 was negatively correlated with the expression of Bcl-2 in IVDD patients. Dual-luciferase reporter gene assay indicated that Bcl-2 was a target gene of miR-195. In comparison with blank group, TNF-α group showed decreased cell proliferation and MMP, increased cell apoptosis, upregulated expression of miR-195, Bax, and cleaved caspase 3, and downregulated Bcl-2 protein, while these changes were attenuated by miR-195 inhibitors. Additionally, siBcl-2 can reverse the protective effect of miR-195 inhibitors on TNF-α-induced NP cells. Besides, inhibition of miR-195 alleviated IVDD degeneration and NP cell apoptosis in the rat model. Conclusion MiR-195 was significantly upregulated in NP tissues of IVDD patients, and inhibition of miR-195 could protect human NP cells from TNF-α-induced apoptosis via upregulation of Bcl-2.

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