Dynamically Crystalizing Liquid-Crystal Elastomers for an Expandable Endplate-Conforming Interbody Fusion Cage

High Strength and Shape Memory Spinal Fusion Device for Minimally Invasive Interbody Fusions

Introduction

Lumbar interbody fusion is widely employed for both acute and chronic spinal diseases interventions. However, large incision created during interbody cage implantation may adversely impair spinal tissue and influence postoperative recovery. The aim of this study was to design a shape memory interbody fusion device suitable for small incision implantation.

Methods

In this study, we designed and fabricated an intervertebral fusion cage that utilizes near-infrared (NIR) light-responsive shape memory characteristics. This cage was composed of bisphenol A diglycidyl ether, polyether amine D-230, decylamine and iron oxide nanoparticles. A self-hardening calcium phosphate-starch cement (CSC) was injected internally through the injection channel of the cage for healing outcome improvement.

Results

The size of the interbody cage is reduced from 22 mm to 8.8 mm to minimize the incision size. Subsequent NIR light irradiation prompted a swift recovery of the cage shape within 5 min at the lesion site. The biocompatibility of the shape memory composite was validated through in vitro MC3T3-E1 cell (osteoblast-like cells) adhesion and proliferation assays and subcutaneous implantation experiments in rats. CSC was injected into the cage, and the relevant results revealed that CSC is uniformly dispersed within the internal space, along with the cage compressive strength increasing from 12 to 20 MPa.

Conclusion

The results from this study thus demonstrated that this integrated approach of using a minimally invasive NIR shape memory spinal fusion cage with CSC has potential for lumbar interbody fusion.

Degradable biomedical elastomers: paving the future of tissue repair and regenerative medicine

Degradable biomedical elastomers (DBE), characterized by controlled biodegradability, excellent biocompatibility, tailored elasticity, and favorable network design and processability, have become indispensable in tissue repair. This review critically examines the recent advances of biodegradable elastomers for tissue repair, focusing mainly on degradation mechanisms and evaluation, synthesis and crosslinking methods, microstructure design, processing techniques, and tissue repair applications. The review explores the material composition and cross-linking methods of elastomers used in tissue repair, addressing chemistry-related challenges and structural design considerations. In addition, this review focuses on the processing methods of two- and three-dimensional structures of elastomers, and systematically discusses the contribution of processing methods such as solvent casting, electrostatic spinning, and three-/four-dimensional printing of DBE. Furthermore, we describe recent advances in tissue repair using DBE, and include advances achieved in regenerating different tissues, including nerves, tendons, muscle, cardiac, and bone, highlighting their efficacy and versatility. The review concludes by discussing the current challenges in material selection, biodegradation, bioactivation, and manufacturing in tissue repair, and suggests future research directions. This concise yet comprehensive analysis aims to provide valuable insights and technical guidance for advances in DBE for tissue engineering.

Liquid Crystal Materials for Biomedical Applications

Liquid crystal is a state of matter being intermediate between solid and liquid. Liquid crystal materials exhibit both orientational order and fluidity. While liquid crystals have long been highly recognized in the display industry, in recent decades, liquid crystals provide new opportunities into the cross-field of material science and biomedicine due to their biocompatibility, multifunctionality, and responsiveness. In this review, the latest achievements of liquid crystal materials applied in biomedical fields are summarized. The start is made by introducing the basic concepts of liquid crystals, and then shifting to the components of liquid crystals as well as functional materials derived therefrom. After that, the ongoing and foreseeable applications of liquid crystal materials in the biomedical field with emphasis put on several cutting-edge aspects, including drug delivery, bioimaging, tissue engineering, implantable devices, biosensing, and wearable devices are discussed. It is hoped that this review will stimulate ingenious ideas for the future generation of liquid crystal-based drug development, artificial implants, disease diagnosis, health status monitoring, and beyond.

Programmable spatial deformation by controllable off-center freestanding 4D printing of continuous fiber reinforced liquid crystal elastomer composites

Owing to their high deformation ability, 4D printed structures have various applications in origami structures, soft robotics and deployable mechanisms. As a material with programmable molecular chain orientation, liquid crystal elastomer is expected to produce the freestanding, bearable and deformable three-dimensional structure. However, majority of the existing 4D printing methods for liquid crystal elastomers can only fabricate planar structures, which limits their deformation designability and bearing capacity. Here we propose a direct ink writing based 4D printing method for freestanding continuous fiber reinforced composites. Continuous fibers can support freestanding structures during the printing process and improve the mechanical property and deformation ability of 4D printed structures. In this paper, the integration of 4D printed structures with fully impregnated composite interfaces, programmable deformation ability and high bearing capacity are realized by adjusting the off-center distribution of the fibers, and the printed liquid crystal composite can carry a load of up to 2805 times its own weight and achieve a bending deformation curvature of 0.33 mm^-1 at 150 °C. This research is expected to open new avenues for creating soft robotics, mechanical metamaterials and artificial muscles.

Skin-friendly and antibacterial monodomain liquid crystal elastomer actuator

Monodomain liquid crystal elastomers (mLCEs) are flexible and biocompatible smart materials that show unique behaviors of soft elasticity, anisotropy, and reversible shape changes above the nematic-isotropic transition temperature. Therefore, it has great potential for application in wearable devices and biologically. However, most of the reported mLCEs have nematic-isotropic transition temperature (T_NI) higher than 60 °C; and above this T_NI, the tensile strength of the mLCEs decreases by orders of magnitude. These issues have received little attention, limiting their application in humans. Herein, the T_NI of mLCEs was reduced from 78.4 °C to 23.5 °C by substituting part of the rigid LC mesogens with a flexible backbone. The physical entanglement of hydrogen bonds between molecular chains alleviated the molecular chain slip caused by the long flexible backbone. The tensile strength remained constant during the phase transformation. Furthermore, dynamic disulfide bonds were used to modify the LC polymer network, imparting it with excellent antimicrobial, programmable, and self-healing properties. To realize its application in the closure of skin wounds, a porous PHG-mLCE/hydrogel patch that was breathable and waterproof was designed to increase skin adhesion (262 N/m).

An update of interbody cages for spine fusion surgeries: from shape design to materials

INTRODUCTION

Discectomy and interbody fusion are widely used in the treatment of intervertebral disc-related diseases. Among them, the interbody cage plays a significant role. However, the complications related to the interbody cage, such as nonunion or pseudoarthrosis, subsidence, loosening, and prolapse of the cage, cannot be ignored. By changing the design and material of the interbody fusion cage, a better fusion effect can be obtained, the incidence of appeal complications can be reduced, and the quality of life of patients after interbody fusion can be improved.

AREAS COVERED

This study reviewed the research progress of cage design and material and discussed the methods of cage design and material to promote intervertebral fusion.

EXPERT OPINION

Current treatment of cervical and lumbar degenerative disease requires interbody fusion to maintain decompression and to promote fusion and reduce the incidence of fusion failure through improvements in implant material, design, internal structure, and function. However, interbody fusion is not an optimal solution for treating vertebral instability.Abbreviations: ACDF, Anterior cervical discectomy and fusion; ALIF, anterior lumbar interbody fusion; Axi-aLIF, axial lumbar interbody fusion; BAK fusion cage, Bagby and Kuslich fusion cage; CADR, cervical artificial disc replacement; DBM, decalcified bone matrix; HA, hydroxyapatite; LLIF/XLIF, lateral or extreme lateral interbody fusion; MIS-TLIF, minimally invasive transforaminal lumbar interbody fusion; OLIF/ATP, oblique lumbar interbody fusion/anterior to psoas; PEEK, Poly-ether-ether-ketone; PLIF, posterior lumbar interbody fusion; ROI-C, Zero-profile Anchored Spacer; ROM, range of motion; SLM, selective melting forming; TLIF, transforaminal lumbar interbody fusion or.

Programmable Shape Change in Semicrystalline Liquid Crystal Elastomers

Liquid crystal elastomers (LCEs) are stimuli-responsive materials capable of reversible and programmable shape change in response to an environmental stimulus. Despite the highly responsive nature of these materials, the modest elastic modulus and blocking stress exhibited by these actuating materials can be limiting in some engineering applications. Here, we engineer a semicrystalline LCE, where the incorporation of semicrystallinity in a lightly cross-linked liquid crystalline network yields tough and highly responsive materials. Directed self-assembly can be employed to program director profiles through the thickness of the semicrystalline LCE. In short, we use the alignment of a liquid crystal monomer phase to pattern the anisotropy of a semicrystalline polymer network. Both the semicrystalline-liquid crystalline and liquid crystalline-isotropic phase transition temperatures provide controllable shape transformations. A planarly aligned sample's normalized dimension parallel to the nematic director decreases from 1 at room temperature to 0.42 at 250 °C. The introduction of the semicrystalline nature also enhances the mechanical properties exhibited by the semicrystalline LCE. Semicrystalline LCEs have a storage modulus of 390 MPa at room temperature, and monodomain samples are capable of generating a contractile stress of 2.7 MPa on heating from 25 to 50 °C, far below the nematic to isotropic transition temperature. The robust mechanical properties of this material combined with the high actuation strain can be leveraged for applications such as soft robotics and actuators capable of doing significant work.

Advances in 4D printing of liquid crystalline elastomers: materials, techniques, and applications

Liquid crystalline elastomers (LCEs) are polymer networks exhibiting anisotropic liquid crystallinity while maintaining elastomeric properties. Owing to diverse polymeric forms and self-alignment molecular behaviors, LCEs have fascinated state-of-the-art efforts in various disciplines other than the traditional low-molar-mass display market. By patterning order to structures, LCEs demonstrate reversible high-speed and large-scale actuations in response to external stimuli, allowing for close integration with 4D printing and architectures of digital devices, which is scarcely observed in homogeneous soft polymer networks. In this review, we collect recent advances in 4D printing of LCEs, with emphases on synthesis and processing methods that enable microscopic changes in the molecular orientation and hence macroscopic changes in the properties of end-use objects. Promising potentials of printed complexes include fields of soft robotics, optics, and biomedical devices. Within this scope, we elucidate the relationships among external stimuli, tailorable morphologies in mesophases of liquid crystals, and programmable topological configurations of printed parts. Lastly, perspectives and potential challenges facing 4D printing of LCEs are discussed.

Liquid Crystalline Elastomers Based on Click Chemistry

Liquid crystalline elastomers (LCEs) have emerged as an important class of functional materials that are suitable for a wide range of applications, such as sensors, actuators, and soft robotics. The unique properties of LCEs originate from the combination between liquid crystal and elastomeric network. The control of macroscopic liquid crystalline orientation and network structure is crucial to realizing the useful functionalities of LCEs. A variety of chemistries have been developed to fabricate LCEs, including hydrosilylation, free radical polymerization of acrylate, and polyaddition of epoxy and carboxylic acid. Over the past few years, the use of click chemistry has become a more robust and energy-efficient way to construct LCEs with desired structures. This article provides an overview of emerging LCEs based on click chemistries, including aza-Michael addition between amine and acrylate, radical-mediated thiol-ene and thiol-yne reactions, base-catalyzed thiol-acrylate and thiol-epoxy reactions, copper-catalyzed azide-alkyne cycloaddition, and Diels-Alder cycloaddition. The similarities and differences of these reactions are discussed, with particular attention focused on the strengths and limitations of each reaction for the preparation of LCEs with controlled structures and orientations. The compatibility of these reactions with the traditional and emerging processing techniques, such as surface alignment and additive manufacturing, are surveyed. Finally, the challenges and opportunities of using click chemistry for the design of LCEs with advanced functionalities and applications are discussed.

Exchangeable Liquid Crystalline Elastomers and Their Applications

This Review presents and discusses the current state of the art in "exchangeable liquid crystalline elastomers", that is, LCE materials utilizing dynamically cross-linked networks capable of reprocessing, reprogramming, and recycling. The focus here is on the chemistry and the specific reaction mechanisms that enable the dynamic bond exchange, of which there is a variety. We compare and contrast these different chemical mechanisms and the key properties of their resulting elastomers. In the conclusion, we discuss the most promising applications that are enabled by dynamic cross-linking and present a summary table: a library of currently available materials and their main characteristics.

Double Networks of Liquid-Crystalline Elastomers with Enhanced Mechanical Strength

Liquid-crystalline elastomers (LCEs) are frequently used in soft actuator development. However, applications are limited because LCEs are prone to mechanical failure when subjected to heavy loads and high temperatures during the working cycle. A mechanically tough LCE system offers larger work capacity and lower failure rate for the actuators. Herein, we adopt the double-network strategy, starting with a siloxane-based exchangeable LCE and developing a series of double-network liquid-crystalline elastomers (DN-LCEs) that are mechanically tougher than the initial elastomer. We incorporate diacrylate reacting monomers to fabricate DN-LCEs, some of which have the breaking stress of 40 MPa. We incorporate thermoplastic polyurethane to fabricate a DN-LCE, achieving an enormous ductility of 90 MJ/m³. We have also attempted to utilize the aza-Michael chemistry to make a DN-LCE that retains high plasticity because of several bond-exchange mechanisms; however, it failed to produce a stable reprocessable LCE system using conventional ester-based reactive mesogens. Each of these DN-LCEs exhibits unique features and characteristics, which are compared and discussed.

4D Printing of Liquid Crystals: What's Right for Me?

Recent years have seen major advances in the developments of both additive manufacturing concepts and responsive materials. When combined as 4D printing, the process can lead to functional materials and devices for use in health, energy generation, sensing, and soft robots. Among responsive materials, liquid crystals, which can deliver programmed, reversible, rapid responses in both air and underwater, are a prime contender for additive manufacturing, given their ease of use and adaptability to many different applications. In this paper, selected works are compared and analyzed to come to a didactical overview of the liquid crystal-additive manufacturing junction. Reading from front to back gives the reader a comprehensive understanding of the options and challenges in the field, while researchers already experienced in either liquid crystals or additive manufacturing are encouraged to scan through the text to see how they can incorporate additive manufacturing or liquid crystals into their own work. The educational text is closed with proposals for future research in this crossover field.

Electrostatic flocking of salt-treated microfibers and nanofiber yarns for regenerative engineering

Electrostatic flocking is a textile technology that employs a Coulombic driving force to launch short fibers from a charging source towards an adhesive-covered substrate, resulting in a dense array of aligned fibers perpendicular to the substrate. However, electrostatic flocking of insulative polymeric fibers remains a challenge due to their insufficient charge accumulation. We report a facile method to flock electrostatically insulative poly(ε-caprolactone) (PCL) microfibers (MFs) and electrospun PCL nanofiber yarns (NFYs) by incorporating NaCl during pre-flock processing. Both MF and NFY were evaluated for flock functionality, mechanical properties, and biological responses. To demonstrate this platform's diverse applications, standalone flocked NFY and MF scaffolds were synthesized and evaluated as scaffold for cell growth. Employing the same methodology, scaffolds made from poly(glycolide-co-_l-lactide) (PGLA) (90:10) MFs were evaluated for their wound healing capacity in a diabetic mouse model. Further, a flock-reinforced polydimethylsiloxane (PDMS) disc was fabricated to create an anisotropic artificial vertebral disc (AVD) replacement potentially used as a treatment for lumbar degenerative disc disease. Overall, a salt-based flocking method is described with MFs and NFYs, with wound healing and AVD repair applications presented.

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NaCl coatings enable sufficient charge accumulation on electrically insulative polymer fibers during electrostatic flocking.

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Flocked nanofiber yarns allow further functionalization of flocked scaffolds.

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Flocked fiber scaffolds sustain cell proliferation.

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Flocked PGLA (90:10) fiber scaffolds promote modest fiber-density dependent wound healing and angiogenesis.

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Flock fibers-reinforced elastomeric artificial vertebral discs are mechanically robust.

Liquid Crystal Elastomer Metamaterials with Giant Biaxial Thermal Shrinkage for Enhancing Skin Regeneration

Liquid crystal elastomers (LCEs) are a class of soft active materials of increasing interest, because of their excellent actuation and optical performances. While LCEs show biomimetic mechanical properties (e.g., elastic modulus and strength) that can be matched with those of soft biological tissues, their biointegrated applications have been rarely explored, in part, due to their high actuation temperatures (typically above 60 °C) and low biaxial actuation performances (e.g., actuation strain typically below 10%). Here, unique mechanics-guided designs and fabrication schemes of LCE metamaterials are developed that allow access to unprecedented biaxial actuation strain (-53%) and biaxial coefficient of thermal expansion (-33 125 ppm K^-1 ), significantly surpassing those (e.g., -20% and -5950 ppm K^-1 ) reported previously. A low-temperature synthesis method with use of optimized composition ratios enables LCE metamaterials to offer reasonably high actuation stresses/strains at a substantially reduced actuation temperature (46 °C). Such biocompatible LCE metamaterials are integrated with medical dressing to develop a breathable, shrinkable, hemostatic patch as a means of noninvasive treatment. In vivo animal experiments of skin repair with both round and cross-shaped wounds demonstrate advantages of the hemostatic patch over conventional strategies (e.g., medical dressing and suturing) in accelerating skin regeneration, while avoiding scar and keloid generation.

Processing advances in liquid crystal elastomers provide a path to biomedical applications

Liquid crystal elastomers (LCEs) are a class of stimuli-responsive polymers that undergo reversible shape-change in response to environmental changes. The shape change of LCEs can be programmed during processing by orienting the liquid crystal phase prior to crosslinking. The suite of processing techniques that has been developed has resulted in a myriad of LCEs with different shape-changing behavior and mechanical properties. Aligning LCEs via mechanical straining yields large uniaxial actuators capable of a moderate force output. Magnetic fields are utilized to control the alignment within LCE microstructures. The generation of out-of-plane deformations such as bending, twisting, and coning is enabled by surface alignment techniques within thin films. 4D printing processes have emerged that enable the fabrication of centimeter-scale, 3D LCE structures with a complex alignment. The processing technique also determines, to a large extent, the potential applications of the LCE. For example, 4D printing enables the fabrication of LCE actuators capable of replicating the forces generated by human muscles. Employing surface alignment techniques, LCE films can be designed for use as coatings or as substrates for stretchable electronics. The growth of new processes and strategies opens and strengthens the path for LCEs to be applicable within biomedical device designs.

Liquid-Crystal-Elastomer-Based Dissipative Structures by Digital Light Processing 3D Printing

Digital Light Processing (DLP) 3D printing enables the creation of hierarchical complex structures with specific micro- and macroscopic architectures that are impossible to achieve through traditional manufacturing methods. Here, this hierarchy is extended to the mesoscopic length scale for optimized devices that dissipate mechanical energy. A photocurable, thus DLP-printable main-chain liquid crystal elastomer (LCE) resin is reported and used to print a variety of complex, high-resolution energy-dissipative devices. Using compressive mechanical testing, the stress-strain responses of 3D-printed LCE lattice structures are shown to have 12 times greater rate-dependence and up to 27 times greater strain-energy dissipation compared to those printed from a commercially available photocurable elastomer resin. The reported behaviors of these structures provide further insight into the much-overlooked energy-dissipation properties of LCEs and can inspire the development of high-energy-absorbing device applications.

Catalytic Control of Plastic Flow in Siloxane-Based Liquid Crystalline Elastomer Networks

Liquid crystalline elastomer networks cross-linked by dynamic covalent bonds (xLCE) have the ability to be (re)processed during the plastic flow. However, the current bond-exchange strategies that are used to induce plastic flow in xLCE lack the efficient method to control the elastic-plastic transition. Here we describe a straightforward method to manipulate the transition to plastic flow via the choice of catalyst in xLCE cross-linked by siloxane. The nature and the amount of catalyst have a profound effect on the elastic-plastic transition temperature, and the stress relaxation behavior of the network. The temperature of fast plastic flow and the associated bond-exchange activation energy varied from 120 °C and 83 kJ/mol in the "fastest" exchange promoted by triazobicyclodecene (TBD) to 240 °C and 164 kJ/mol in the "slowest" exchange with triphenylphosphine (PPH), with a range of catalysts in between. We have identified the optimum conditions for programming an aligned monodomain xLCE, high programming temperature (230 °C) and low nematic to isotropic transition (60 °C), to achieve thermally and mechanically stable actuators.

Toward Programmed Complex Stress-Induced Mechanical Deformations of Liquid Crystal Elastomers

We prepare a liquid crystal elastomer (LCE) with a spatially patterned liquid crystal director field from an all-acrylate LCE. Mechanical deformations of this material lead to a complex and spatially varying deformation with localised body rotations, shears and extensions. Together, these dictate the evolved shape of the deformed film. Using polarising microscopy, we map the local rotation of the liquid crystal director in Eulerian and Lagrangian frames and use these to determine rules for programming complex, stress-induced mechanical shape deformations of LCEs. Moreover, by applying a recently developed empirical model for the mechanical behaviour of our LCE, we predict the non-uniform stress distributions in our material. These results show the promise of empirical approaches to modelling the anisotropic and nonlinear mechanical responses of LCEs which will be important as the community moves toward realising real-world, LCE-based devices.