scholarly journals Disc nucleus fortification for lumbar degenerative disc disease: a biomechanical study

2016 ◽  
Vol 24 (5) ◽  
pp. 708-714 ◽  
Author(s):  
Derrick A. Dupré ◽  
Daniel J. Cook ◽  
J. Brad Bellotte ◽  
Michael Y. Oh ◽  
Donald Whiting ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Hysteresis Loops ◽  
Intervertebral Discs ◽  
Biomechanical Study ◽  
Load Testing ◽  
Disc Disease ◽  
Partial Restoration ◽  
Disc Bulge ◽  
Posterior Elements

OBJECTIVE Spinal stability is attributed in part to osteoligamentous structures, including the vertebral body, facets, intervertebral discs, and posterior elements. The materials in this study provide an opportunity to augment the degenerated nucleus without removing native disc material, a procedure introduced here as “fortification.” The objective of this study was to determine the effect of nucleus fortification on lumbar disc biomechanics. METHODS The authors performed in vitro analysis of human cadaveric functional spinal units (FSUs), along with characterization and quantification of movement of the units using biomechanical data in intact, disc-only, and fortified specimens. The units underwent removal of all posterior elements and annulus and were fortified by injecting a biogel into the nucleus pulposus. Each specimen was subjected to load testing, range of motion (ROM) quantification, and disc bulge measurements. Optoelectric tracking was used to quantify disc bulge. These criteria were assessed in the intact, disc-only, and fortified treatments. RESULTS Disc-only FSUs resulted in increased ROM when compared with intact and fortified conditions. Fortification of the FSU resulted in partial restoration of normal ROM in the treatment groups. Analysis of hysteresis loops showed more linear response in the fortified groups when compared with the intact and disc-only groups. CONCLUSIONS Disc nucleus fortification increases linearity and decreases ROM.

scholarly journals Pro-Inflammatory and Neurotrophic Factor Responses of Cells Derived from Degenerative Human Intervertebral Discs to the Opportunistic Pathogen Cutibacterium acnes

2021 ◽  
Vol 22 (5) ◽  
pp. 2347
Author(s):  
Manu N. Capoor ◽  
Anna Konieczna ◽  
Andrew McDowell ◽  
Filip Ruzicka ◽  
Martin Smrcka ◽  
...  
Keyword(s):  
Neurotrophic Factor ◽  
Acne Vulgaris ◽  
Opportunistic Pathogen ◽  
Intervertebral Discs ◽  
Disc Disease ◽  
Gene Target ◽  
Cutibacterium Acnes ◽  
Pre Treatment

Previously, we proposed the hypothesis that similarities in the inflammatory response observed in acne vulgaris and degenerative disc disease (DDD), especially the central role of interleukin (IL)-1β, may be further evidence of the role of the anaerobic bacterium Cutibacterium (previously Propionibacterium) acnes in the underlying aetiology of disc degeneration. To investigate this, we examined the upregulation of IL-1β, and other known IL-1β-induced inflammatory markers and neurotrophic factors, from nucleus-pulposus-derived disc cells infected in vitro with C. acnes for up to 48 h. Upon infection, significant upregulation of IL-1β, alongside IL-6, IL-8, chemokine (C-C motif) ligand 3 (CCL3), chemokine (C-C motif) ligand 4 (CCL4), nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), was observed with cells isolated from the degenerative discs of eight patients versus non-infected controls. Expression levels did, however, depend on gene target, multiplicity and period of infection and, notably, donor response. Pre-treatment of cells with clindamycin prior to infection significantly reduced the production of pro-inflammatory mediators. This study confirms that C. acnes can stimulate the expression of IL-1β and other host molecules previously associated with pathological changes in disc tissue, including neo-innervation. While still controversial, the role of C. acnes in DDD remains biologically credible, and its ability to cause disease likely reflects a combination of factors, particularly individualised response to infection.

Biomechanics of the Lumbar Disc

1997 ◽  
Vol 01 (02) ◽  
pp. 81-94 ◽  
Author(s):  
V. K. Goel ◽  
N. M. Grosland ◽  
J. Scifert
Keyword(s):  
Morphological Changes ◽  
Imaging Techniques ◽  
Lumbar Disc ◽  
Analytical Models ◽  
Clinical Observations ◽  
Disc Bulge ◽  
Mechanical Factors ◽  
Methods Analytical

The human disc and the facets work in unison to transmit loads across a lumbar motion segment. For this reason, if one component is affected by the degenerative process, the other follows. Modern imaging techniques and clinical observations have adequately delineated morphological changes in the spinal structures, while in vitro biomechanical studies have revealed that repetitive complex loads may lead to loosening of spinal structures, annular tears, and herniated discs. In addition to such experimental methods, analytical models have been able to explain the role of mechanical factors in producing disc degeneration and herniation. Furthermore, these techniques are applicable to investigating various surgical stabilization procedures. From a biomechanical perspective, surgical procedures such as discectomy are effective in reducing pain due to a decrease in disc bulge following surgery. Excessive instability across the disc, however, may require the use of bone grafts, cages or other types of interbody spacers to restore disc height. Efforts are currently underway to restore disc mechanics via an artificial disc. The following review is aimed at outlining the role of mechanical foctors in both inducing and stabilizing the degenerated/herniated intervertebral disc.

A Novel and Inexpensive Technique for High-tension Tendon Clamping with Expandable Mesh Sleeving for in Vitro Foot Biomechanics Testing

2021 ◽  
Author(s):  
Joshua L. Golubovsky ◽  
Callan M Gillespie ◽  
Tara F. Nagle ◽  
Jeremy G Loss ◽  
Robb Colbrunn
Keyword(s):  
Biomechanical Testing ◽  
Biomechanical Study ◽  
Load Testing ◽  
Foot Biomechanics ◽  
High Tension ◽  
Low Load ◽  
Wire Meshes ◽  
Study Designs ◽  
Novel Devices

Abstract In vitro biomechanical testing is common in the field of orthopedics when novel devices are investigated prior to human trials. It is typically necessary to apply loads through tendons to simulate normal activities, such as walking during a foot and ankle study. However, attachment of tendons to linear actuators has proven challenging because of the tendency of clamps to either slip off or rupture the tendon. Freeze clamping is generally accepted as the gold standard for very high load testing in excess of 3000 N, but is expensive, time-consuming, and requires significant ancillary equipment. Purely mechanical solutions such as metal jaw clamps, wire meshes, and others have been explored, but these techniques are either costly, have low load capacities, or have not proven to be reproducible. We have developed a novel tendon clamping technique that utilizes a slip-resistant polyester mesh sleeving that encases the tendon and is fixated at the bottom of the tendon/sleeve interaction with a giftbox suture. The loose end of the sleeving can then be tied in to the linear actuator or load cell apparatus using a timber hitch knot. The sleeving technique allows for loads of 2000-2500 N on the Achilles tendon, and is inexpensive, reproducible, and can be modified to apply loads to smaller tendons as well, though a length of tendon/sleeve overlap of at least 16 cm is required to reach maximum loads. This technique should assist researchers in integrating muscle forces into future biomechanical study designs.

The Effect of Volarly Angulated Distal Radius Fractures on Forearm Rotation: In Vitro Biomechanical Study

2015 ◽  
Vol 04 (S 01) ◽  
Author(s):  
Masao Nishiwaki ◽  
Mark Welsh ◽  
Louis Ferreira ◽  
James Johnson ◽  
Graham King ◽  
...  
Keyword(s):  
Distal Radius ◽  
Biomechanical Study ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Forearm Rotation

A Novel Non-invasive Effective Method for Potential Treatment of Degenerative Disc Disease: A Hypothesis

2019 ◽  
Vol 19 (1) ◽  
pp. 8-14
Author(s):  
Siva G. Somasundaram ◽  
Cristian Muresanu ◽  
Pamela Schield ◽  
Alfiya Makhmutovа ◽  
Elena V. Bovina ◽  
...  
Keyword(s):  
Transforming Growth Factor ◽  
Single Case ◽  
Life Quality ◽  
Transforming Growth Factor Β1 ◽  
Intervertebral Discs ◽  
Review Literature ◽  
Background Information ◽  
Disc Disease ◽  
Case Study Report ◽  
Osteogenic Protein

The pathophysiology of the intervertebral discs plays a significant role in the people’s life quality. There is not adequate research done in the pathogenesis and treatment of intervertebral disc degeneration. Alternately, self-educated physiology offers a novel and noninvasive method to reverse the degenerated discs. In this single case study, report attempts have been made to highlight the effect of the self-educative physiology, on magnetic resonance imaging investigations, of progressive healing, on the degenerated intervertebral discs. Based on this novel method, an effort has been made to review literature on the degeneration of intervertebral discs and available mode of treatments and then to propose a hypothesis for the biochemical mechanisms of healing. The idea is that transforming growth factor-β1 from seminal plasma secretions may contribute to releasing the osteogenic protein- 1 which induces nucleus pulposus and annulus fibrosus cells in intervertebral discs for repairs. In addition, the patient’s medical history is presented with background information.

Role of the anconeus in the stability of a lateral ligament and common extensor origin–deficient elbow: an in vitro biomechanical study

2019 ◽  
Vol 28 (5) ◽  
pp. 974-981 ◽  
Author(s):  
Armin Badre ◽  
David T. Axford ◽  
Sara Banayan ◽  
James A. Johnson ◽  
Graham J.W. King
Keyword(s):  
Biomechanical Study ◽  
Lateral Ligament ◽  
The Stability

scholarly journals Quantification of assembly forces during creation of head-neck taper junction considering soft tissue bearing: a biomechanical study

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Toni Wendler ◽  
Torsten Prietzel ◽  
Robert Möbius ◽  
Jean-Pierre Fischer ◽  
Andreas Roth ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Work Experience ◽  
Soft Tissues ◽  
Force Sensor ◽  
Biomechanical Study ◽  
Measuring System ◽  
Wide Range ◽  
Head Neck

Abstract Background All current total hip arthroplasty (THA) systems are modular in design. Only during the operation femoral head and stem get connected by a Morse taper junction. The junction is realized by hammer blows from the surgeon. Decisive for the junction strength is the maximum force acting once in the direction of the neck axis, which is mainly influenced by the applied impulse and surrounding soft tissues. This leads to large differences in assembly forces between the surgeries. This study aimed to quantify the assembly forces of different surgeons under influence of surrounding soft tissue. Methods First, a measuring system, consisting of a prosthesis and a hammer, was developed. Both components are equipped with a piezoelectric force sensor. Initially, in situ experiments on human cadavers were carried out using this system in order to determine the actual assembly forces and to characterize the influence of human soft tissues. Afterwards, an in vitro model in the form of an artificial femur (Sawbones Europe AB, Malmo, Sweden) with implanted measuring stem embedded in gelatine was developed. The gelatine mixture was chosen in such a way that assembly forces applied to the model corresponded to those in situ. A study involving 31 surgeons was carried out on the aforementioned in vitro model, in which the assembly forces were determined. Results A model was developed, with the influence of human soft tissues being taken into account. The assembly forces measured on the in vitro model were, on average, 2037.2 N ± 724.9 N, ranging from 822.5 N to 3835.2 N. The comparison among the surgeons showed no significant differences in sex (P = 0.09), work experience (P = 0.71) and number of THAs performed per year (P = 0.69). Conclusions All measured assembly forces were below 4 kN, which is recommended in the literature. This could lead to increased corrosion following fretting in the head-neck interface. In addition, there was a very wide range of assembly forces among the surgeons, although other influencing factors such as different implant sizes or materials were not taken into account. To ensure optimal assembly force, the impaction should be standardized, e.g., by using an appropriate surgical instrument.

scholarly journals Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

2021 ◽  
pp. 219256822199836
Author(s):  
Sathish Muthu ◽  
Madhan Jeyaraman ◽  
Girinivasan Chellamuthu ◽  
Naveen Jeyaraman ◽  
Rashmi Jain ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Platelet Rich Plasma ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Beneficial Role ◽  
Sf 36

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease. Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, and Cochrane Library till September 2020 for studies investigating the role of intradiscal PRP in the management of lumbar disc disease. The analysis was performed in the R platform using OpenMeta[Analyst] software. Results: 13 studies including 2 RCTs, 5 prospective, and 6 retrospective studies involving 319 patients were included in the meta-analysis. A single-arm meta-analysis of the included studies showed a beneficial effect of the intervention in terms of pain relief outcomes like VAS score (p < 0.001), pain component of SF-36 (p = 0.003) while such improvement was not seen in functional outcome measures like ODI score (p = 0.071), the physical component of SF-36 (p = 0.130) with significant heterogeneity noted among the included studies. No structural improvement in magnetic resonance imaging was observed (p = 0.106). No additional procedure-related adverse events were noted in the included studies (p = 0.662). Conclusion: There is a paucity of high-quality studies to give conclusive evidence on the benefits of intradiscal PRP for lumbar disc disease. Although intradiscal PRP injection has shown some beneficial effect in controlling pain for lumbar disc disease, we could not find structural or functional improvement from the included studies. Hence, we recommend large double-blind double-arm randomized controlled studies to analyze the benefits of the intervention being analyzed.

scholarly journals Whether sutures reduce the graft laceration caused by interference screw in anterior cruciate ligament reconstruction? A biomechanical study in vitro

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuanjun Teng ◽  
Xiaohui Zhang ◽  
Lijun Da ◽  
Jie Hu ◽  
Hong Wang ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Interference Screw ◽  
Biomechanical Study ◽  
Interference Screws ◽  
Suture Group ◽  
Anterior Cruciate ◽  
Biomechanical Tests ◽  
Single Insertion

Abstract Background Interference screw is commonly used for graft fixation in anterior cruciate ligament (ACL) reconstruction. However, previous studies had reported that the insertion of interference screws significantly caused graft laceration. The purposes of this study were to (1) quantitatively evaluate the graft laceration from one single insertion of PEEK interference screws; and (2) determine whether different types of sutures reduced the graft laceration after one single insertion of interference screws in ACL reconstruction. Methods The in-vitro ACL reconstruction model was created using porcine tibias and bovine extensor digitorum tendons of bovine hind limbs. The ends of grafts were sutured using three different sutures, including the bioabsorbable, Ethibond and ultra-high molecular weight polyethylene (UHMWPE) sutures. Poly-ether-ether-ketone (PEEK) interference screws were used for tibial fixation. This study was divided into five groups (n = 10 in each group): the non-fixed group, the non-sutured group, the absorbable suture group, the Ethibond suture group and the UHMWPE suture group. Biomechanical tests were performed using the mode of pull-to-failure loading tests at 10 mm/min. Tensile stiffness (newtons per millimeter), energy absorbed to failure (in joules) and ultimate load (newtons) were recorded for analysis. Results All prepared tendons and bone specimens showed similar characteristics (length, weight, and pre-tension of the tendons, tibial bone mineral density) among all groups (P > 0.05). The biomechanical tests demonstrated that PEEK interference screws significantly caused the graft laceration (P < 0.05). However, all sutures (the bioabsorbable, Ethibond and UHMWPE sutures) did not reduce the graft laceration in ACL reconstruction (P > 0.05). Conclusions Our biomechanical study suggested that the ultimate failure load of grafts was reduced of approximately 25 % after one single insertion of a PEEK interference screw in ACL reconstruction. Suturing the ends of the grafts using different sutures (absorbable, Ethibond and UHMWPE sutures) did not decrease the graft laceration caused by interference screws.

Sign in / Sign up

Export Citation Format

Share Document