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Feki F, Taktak R, Haddar N, Moulart M, Zaïri F, Zaïri F. Overloading effect on the osmo-viscoelastic and recovery behavior of the intervertebral disc. Proc Inst Mech Eng H 2024; 238:430-437. [PMID: 38480472 DOI: 10.1177/09544119241232286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
In vitro studies investigating the effect of high physiological compressive loads on the intervertebral disc mechanics as well as on its recovery are rare. Moreover, the osmolarity effect on the disc viscoelastic behavior following an overloading is far from being studied. This study aims to determine whether a compressive loading-unloading cycle exceeding physiological limits could be detrimental to the cervical disc, and to examine the chemo-mechanical dependence of this overloading effect. Cervical functional spine units were subjected to a compressive loading-unloading cycle at a high physiological level (displacement of 2.5 mm). The overloading effect on the disc viscoelastic behavior was evaluated through two relaxation tests conducted before and after cyclic loading. Afterward, the disc was unloaded in a saline bath during a rest period, and its recovery response was assessed by a third relaxation test. The chemo-mechanical coupling in the disc response was further examined by repeating this protocol with three different saline concentrations in the external fluid bath. It was found that overloading significantly alters the disc viscoelastic response, with changes statistically dependent on osmolarity conditions. The applied hyper-physiological compressive cycle does not cause damage since the disc recovers its original viscoelastic behavior following a rest period. Osmotic loading only influences the loading-unloading response; specifically, increasing fluid osmolarity leads to a decrease in disc relaxation after the applied cycle. However, the disc recovery is not impacted by the osmolarity of the external fluid.
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Affiliation(s)
- Faten Feki
- Materials Engineering and Environment Laboratory (LGME), ENIS, Sfax University, Sfax, Tunisia
| | - Rym Taktak
- Laboratory of Advanced Material (LMA), ENIS, Sfax University, Sfax, Tunisia
| | - Nader Haddar
- Materials Engineering and Environment Laboratory (LGME), ENIS, Sfax University, Sfax, Tunisia
| | | | - Fahmi Zaïri
- Université de Lille, IMT Nord Europe, JUNIA, Université d'Artois, ULR 4515 - Laboratoire de Génie Civil et géo-Environnement, Lille, France
| | - Fahed Zaïri
- Ramsay Générale de Santé, Hôpital privé Le Bois, Lille, France
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Rivera Tapia ED, Meakin JR, Holsgrove TP. A novel in-vitro model of intervertebral disc degeneration using hyperphysiological loading. J Biomech 2024; 167:112068. [PMID: 38582004 DOI: 10.1016/j.jbiomech.2024.112068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
Intervertebral disc (IVD) degeneration includes changes in tissue biomechanics, physical attributes, biochemical composition, disc microstructure, and cellularity, which can all affect the normal function of the IVD, and ultimately may lead to pain. The purpose of this research was to develop an in-vitro model of degeneration that includes the evaluation of physical, biomechanical, and structural parameters, and that does so over several load/recovery periods. Hyperphysiological loading was used as the degenerative initiator with three experimental groups employed using bovine coccygeal IVD specimens: Control; Single-Overload; and Double-Overload. An equilibrium stage comprising a static load followed by two load/recovery periods was followed by six further load/recovery periods. In the Control group all load/recovery periods were the same, comprising physiological cyclic loading. The overload groups differed in that hyperphysiological loading was applied during the 4th loading period (Single-Overload), or the 4th and 5th loading period (Double-Overload). Overloading led to a significant reduction in disc height compared to the Control group, which was not recovered in subsequent physiological load/recovery periods. However, there were no significant changes in stiffness. Overloading also led to significantly more microstructural damage compared to the Control group. Taking all outcome measures into account, the overload groups were evaluated as replicating clinically relevant aspects of moderate IVD degeneration. Further research into a potential dose-effect, and how more severe degeneration can be replicated would provide a model with the potential to evaluate new treatments and interventions for different stages of IVD degeneration.
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Affiliation(s)
- E D Rivera Tapia
- Department of Engineering, Faculty of Environment, Science and Economy, University of Exeter, Exeter, United Kingdom
| | - J R Meakin
- Department of Physics and Astronomy, Faculty of Environment, Science and Economy, University of Exeter, Exeter, United Kingdom
| | - T P Holsgrove
- Department of Engineering, Faculty of Environment, Science and Economy, University of Exeter, Exeter, United Kingdom.
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Determinants of diurnal variation in lumbar intervertebral discs and paraspinal muscles: A prospective quantitative magnetic resonance imaging study. Eur J Radiol 2023; 160:110712. [PMID: 36720179 DOI: 10.1016/j.ejrad.2023.110712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE To prospectively investigate the determinants of diurnal variations in lumbar intervertebral discs and paraspinal muscles. METHOD 71 females aged 19 ∼ 31 years were examined by morning-evening T2 mapping/diffusion kurtosis imaging (DKI), with weight and lifestyle information (time in night bed-rest [TIB], bed-napping, activity time, and sitting time) assessed by standardized questionnaires. Diurnal shifts in T2, mean diffusivity and mean kurtosis (T2-DS, MD-DS and MK-DS; morning-value minus evening-value) were evaluated for L4-S1 discs (normal, Pfirrmann grade Ⅰ/Ⅱ; degenerative, III/IV). T2 and T2-DS were assessed for L4/5 multifidus and erector spinalis. RESULTS For normal discs, bed-napping correlated with MD-DS and MK-DS in disc entirety (p = 0.001 and 0.004); increased activity time suggested higher T2-DS in nucleus pulposus (p = 0.004); prolonged sitting time predicted greater T2-DS in disc entirety and posterior inner annulus fibrosus (PI-AF, p ≤ 0.011); decreased TIB and weight suggested lower T2-DS and higher MK-DS in PI-AF (p = 0.001 ∼ 0.035). For degenerative discs, bed-napping predicted lower T2-DS in nucleus pulposus and PI-AF (p = 0.019); increased TIBsuggested higher T2-DS and lower MK-DS in PI-AF (p = 0.006 and 0.034); longer sitting time predicted higher MK-DS in PI-AF (p = 0.020). Paraspinal muscles exhibited diurnal T2 variation (p < 0.001) which did not correlate with lifestyle factors (p > 0.050). CONCLUSIONS Lifestyle and weight have causal effects on the diurnal variation of lumbar discs. Bed-rest may correlate with disc hydration and microstructural stability reserves for subsequent daytime activities. Sitting behavior could induce greater dehydration in normal discs and may alleviate diurnal microstructural rearrangement in degenerative discs. T2 mapping and DKI are promising tools to evaluate disc biomechanics in clinics.
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Effects of Fluid Shear Stress on Human Intervertebral Disc Nucleus Pulposus Cells Based on Label-Free Quantitative Proteomics. DISEASE MARKERS 2022; 2022:3860898. [PMID: 36157212 PMCID: PMC9492342 DOI: 10.1155/2022/3860898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/04/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the possible mechanism of fluid shear stress on human nucleus pulposus cells based on label-free proteomics technology. Methods The human nucleus pulposus cell line was purchased and subcultured in vitro. The Flexcell STR-4000 multiflow field cell fluid shear stress loading culture system was used to apply continuous laminar fluid shear stress (12 dyne/cm2, 45 mins) to the monolayer adherent cells. Those without mechanical loading were used as the control group, and those subjected to fluid shear loading were used as the experimental group. Differential protein expression was identified using mass spectrometry identification technology, and bioinformatics analysis was performed using Gene Ontology GO (Gene Ontology) and Kyoto Encyclopedia of Genes and Genomes KEGG (Kyoto Encyclopedia of Genes and Genomes). Results The proteomics results of the experimental group and the control group showed that the total number of mass spectra was 638653, the number of matched mass spectra was 170110, the total number of identified peptides was 32050, the specific peptide was 30564, and the total number of identified proteins was 4745. Comparing the two groups, 47 proteins were significantly differentially expressed, namely, 25 upregulated proteins and 22 downregulated proteins. Bioinformatics analysis showed that significantly different proteins were mainly manifested in cellular process, biological regulation, metabolic process, binding, catalytic activity, cellular components (cell part), organelle part (organelle part), and other molecular biological functions. Conclusion Using proteomics technology to screen human nucleus pulposus cells after fluid shear stress loading, the differential protein expression provides a basis for further exploration of the mechanism of mechanical factors on nucleus pulposus.
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Saiklang P, Puntumetakul R, Selfe J, Yeowell G. An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers. HUMAN FACTORS 2022; 64:820-834. [PMID: 33111563 DOI: 10.1177/0018720820966082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants. BACKGROUND Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain. METHOD Thirty participants with CLBP were randomly allocated: (a) control-sitting without exercise, and (b) intervention-supported dynamic lumbar extension with the ADIM technique. RESULTS Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting. CONCLUSION The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP. APPLICATION Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.
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Liu C, Wang J, Hou B, Li Y, Morelli JN, Zhang P, Ran J, Li X. Diurnal Variation in Hydration of the Cervical Intervertebral Disc Assessed Using T2 Mapping of Magnetic Resonance Imaging. Korean J Radiol 2022; 23:638-648. [PMID: 35617994 PMCID: PMC9174496 DOI: 10.3348/kjr.2021.0950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/10/2022] [Accepted: 04/01/2022] [Indexed: 11/15/2022] Open
Abstract
Objective The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods C3–C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2–C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 – evening T2)/morning T2 × 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.
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Affiliation(s)
- Chanyuan Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingyi Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bowen Hou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yitong Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - John N Morelli
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peisen Zhang
- Department of Rehabilitation Medicine, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
| | - Jun Ran
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoming Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Yang M, Xiang D, Wang S, Liu W. In Vitro Studies for Investigating Creep of Intervertebral Discs under Axial Compression: A Review of Testing Environment and Results. MATERIALS 2022; 15:ma15072500. [PMID: 35407833 PMCID: PMC9000064 DOI: 10.3390/ma15072500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 01/06/2023]
Abstract
Creep responses of intervertebral discs (IVDs) are essential for spinal biomechanics clarification. Yet, there still lacks a well-recognized investigation protocol for this phenomenon. Current work aims at providing researchers with an overview of the in vitro creep tests reported by previous studies, specifically specimen species, testing environment, loading regimes and major results, based on which a preliminary consensus that may guide future creep studies is proposed. Specimens used in creep studies can be simplified as a “bone–disc–bone” structure where three mathematical models can be adopted for describing IVDs’ responses. The preload of 10–50 N for 30 min or three cycles followed by 4 h-creep under constant compression is recommended for ex vivo simulation of physiological condition of long-time sitting or lying. It is worth noticing that species of specimens, environment temperature and humidity all have influences on biomechanical behaviors, and thus are summarized and compared through the literature review. All factors should be carefully set according to a guideline before tests are conducted to urge comparable results across studies. To this end, this review also provides a guideline, as mentioned before, and specific steps that might facilitate the community of biomechanics to obtain more repeatable and comparable results from both natural specimens and novel biomaterials.
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Affiliation(s)
- Mengying Yang
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China;
- State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China;
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Dingding Xiang
- State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China;
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang 110819, China
| | - Song Wang
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
- Correspondence: (S.W.); (W.L.)
| | - Weiqiang Liu
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China;
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
- Correspondence: (S.W.); (W.L.)
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Yamada K, Iwasaki N, Sudo H. Biomaterials and Cell-Based Regenerative Therapies for Intervertebral Disc Degeneration with a Focus on Biological and Biomechanical Functional Repair: Targeting Treatments for Disc Herniation. Cells 2022; 11:602. [PMID: 35203253 PMCID: PMC8870062 DOI: 10.3390/cells11040602] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/22/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
Intervertebral disc (IVD) degeneration is a common cause of low back pain and most spinal disorders. As IVD degeneration is a major obstacle to the healthy life of so many individuals, it is a major issue that needs to be overcome. Currently, there is no clinical treatment for the regeneration of degenerated IVDs. However, recent advances in regenerative medicine and tissue engineering suggest the potential of cell-based and/or biomaterial-based IVD regeneration therapies. These treatments may be indicated for patients with IVDs in the intermediate degenerative stage, a point where the number of viable cells decreases, and the structural integrity of the disc begins to collapse. However, there are many biological, biomechanical, and clinical challenges that must be overcome before the clinical application of these IVD regeneration therapies can be realized. This review summarizes the basic research and clinical trials literature on cell-based and biomaterial-based IVD regenerative therapies and outlines the important role of these strategies in regenerative treatment for IVD degenerative diseases, especially disc herniation.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
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Saiklang P, Puntumetakul R, Chatprem T. The Effect of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique on Stature Change during Prolonged Sitting in Sedentary Workers with Chronic Low Back Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031904. [PMID: 35162924 PMCID: PMC8835683 DOI: 10.3390/ijerph19031904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/30/2022] [Accepted: 02/05/2022] [Indexed: 01/27/2023]
Abstract
To enhance stature recovery, lumbar spine stabilization by stimulating the deep trunk muscle activation for compensation forces originating from the upper body was introduced. The abdominal drawing-in maneuver (ADIM) technique has been found mainly to activate deep trunk muscles. The purpose of the current study was to determine whether 5 weeks of training of deep trunk muscles using the ADIM technique could improve stature recovery, delay trunk muscle fatigue, and decrease pain intensity during prolonged sitting. Thirty participants with chronic low back pain (CLBP) conducted a core stabilization exercise (CSE) with the ADIM technique for 5 weeks. Participants were required to sit for 41 min before and after the exercise intervention. Stature change was measured using a seated stadiometer with a resolution of ±0.006 mm. During sitting, the stature change, pain intensity, and trunk muscle fatigue were recorded. A comparison between measurements at baseline and after 5 weeks of training demonstrated: (i) stature recovery and pain intensity significantly improved throughout the 41 min sitting condition; (ii) the bilaterally trunk muscle showed significantly decreased fatigue. The CSE with the ADIM technique was shown to provide a protective effect on detrimental reductions in stature change and trunk muscle fatigue during prolonged sitting in young participants under controlled conditions in a laboratory. This information may help to prevent the risk of LBP from prolonged sitting activities in real life situations.
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Affiliation(s)
- Pongsatorn Saiklang
- Division of Physical Therapy, Faculty of Physical Therapy, Srinakharinwiroj University, Nakhonnayok 26120, Thailand;
| | - Rungthip Puntumetakul
- Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen 40002, Thailand;
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Correspondence:
| | - Thiwaphon Chatprem
- Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen 40002, Thailand;
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Dixon AR, Warren JP, Culbert MP, Mengoni M, Wilcox RK. Review of in vitro mechanical testing for intervertebral disc injectable biomaterials. J Mech Behav Biomed Mater 2021; 123:104703. [PMID: 34365096 DOI: 10.1016/j.jmbbm.2021.104703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/22/2021] [Accepted: 07/03/2021] [Indexed: 01/17/2023]
Abstract
Many early stage interventions for intervertebral disc degeneration are under development involving injection of a biomaterial into the affected tissue. Due to the complex mechanical behaviour of the intervertebral disc, there are challenges in comprehensively evaluating the performance of these injectable biomaterials in vitro. The aim of this review was to examine the different methods that have been developed to mechanically test injectable intervertebral disc biomaterials in an in vitro disc model. Testing methods were examined with emphasis on overall protocol, artificial degeneration method, mechanical testing regimes and injection delivery. Specifically, the effects of these factors on the evaluation of different aspects of device performance was assessed. Broad testing protocols varied between studies and enabled evaluation of different aspects of an injectable treatment. Studies employed artificial degeneration methodologies which were either on a macro scale through mechanical means or on a microscale with biochemical means. Mechanical loading regimes differed greatly across studies, with load being either held constant, ramped to failure, or applied cyclically, with large variability on all loading parameters. Evaluation of the risk of herniation was possible by utilising ramped loading, whereas cyclic loading enabled the examination of the restoration of mechanical behaviour for initial screening of biomaterials and surgical technique optimisation studies. However, there are large variations in the duration or tests, and further work is needed to define an appropriate number of cycles to standardise this type of testing. Biomaterial delivery was controlled by set volume or haptic feedback, and future investigations should generate evidence applying physiological loading during injection and normalisation of injection parameters based on disc size. Based on the reviewed articles and considering clinical risks, a series of recommendations have been made for future intervertebral disc mechanical testing.
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Affiliation(s)
- A R Dixon
- University of Leeds, Institute of Medical and Biological Engineering, Leeds, LS2 9JT, United Kingdom.
| | - J P Warren
- University of Leeds, Institute of Medical and Biological Engineering, Leeds, LS2 9JT, United Kingdom
| | - M P Culbert
- University of Leeds, Institute of Medical and Biological Engineering, Leeds, LS2 9JT, United Kingdom
| | - M Mengoni
- University of Leeds, Institute of Medical and Biological Engineering, Leeds, LS2 9JT, United Kingdom
| | - R K Wilcox
- University of Leeds, Institute of Medical and Biological Engineering, Leeds, LS2 9JT, United Kingdom.
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Lee NN, Salzer E, Bach FC, Bonilla AF, Cook JL, Gazit Z, Grad S, Ito K, Smith LJ, Vernengo A, Wilke H, Engiles JB, Tryfonidou MA. A comprehensive tool box for large animal studies of intervertebral disc degeneration. JOR Spine 2021; 4:e1162. [PMID: 34337336 PMCID: PMC8313180 DOI: 10.1002/jsp2.1162] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022] Open
Abstract
Preclinical studies involving large animal models aim to recapitulate the clinical situation as much as possible and bridge the gap from benchtop to bedside. To date, studies investigating intervertebral disc (IVD) degeneration and regeneration in large animal models have utilized a wide spectrum of methodologies for outcome evaluation. This paper aims to consolidate available knowledge, expertise, and experience in large animal preclinical models of IVD degeneration to create a comprehensive tool box of anatomical and functional outcomes. Herein, we present a Large Animal IVD Scoring Algorithm based on three scales: macroscopic (gross morphology, imaging, and biomechanics), microscopic (histological, biochemical, and biomolecular analyses), and clinical (neurologic state, mobility, and pain). The proposed algorithm encompasses a stepwise evaluation on all three scales, including spinal pain assessment, and relevant structural and functional components of IVD health and disease. This comprehensive tool box was designed for four commonly used preclinical large animal models (dog, pig, goat, and sheep) in order to facilitate standardization and applicability. Furthermore, it is intended to facilitate comparison across studies while discerning relevant differences between species within the context of outcomes with the goal to enhance veterinary clinical relevance as well. Current major challenges in pre-clinical large animal models for IVD regeneration are highlighted and insights into future directions that may improve the understanding of the underlying pathologies are discussed. As such, the IVD research community can deepen its exploration of the molecular, cellular, structural, and biomechanical changes that occur with IVD degeneration and regeneration, paving the path for clinically relevant therapeutic strategies.
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Affiliation(s)
- Naomi N. Lee
- Thompson Laboratory for Regenerative OrthopaedicsUniversity of MissouriColumbiaMissouriUSA
| | - Elias Salzer
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Frances C. Bach
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Andres F. Bonilla
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityColoradoUSA
| | - James L. Cook
- Thompson Laboratory for Regenerative OrthopaedicsUniversity of MissouriColumbiaMissouriUSA
| | - Zulma Gazit
- Department of SurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | | | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Lachlan J. Smith
- Departments of Neurosurgery and Orthopaedic SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Andrea Vernengo
- AO Research Institute DavosDavosSwitzerland
- Department of Chemical EngineeringRowan UniversityGlassboroNew JerseyUSA
| | - Hans‐Joachim Wilke
- Institute of Orthopaedic Research and BiomechanicsUniversity Hospital UlmUlmGermany
| | - Julie B. Engiles
- Department of Pathobiology, New Bolton Center, School of Veterinary MedicineUniversity of PennsylvaniaKennett SquarePennsylvaniaUSA
| | - Marianna A. Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
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Saiklang P, Puntumetakul R, Swangnetr Neubert M, Boucaut R. The immediate effect of the abdominal drawing-in maneuver technique on stature change in seated sedentary workers with chronic low back pain. ERGONOMICS 2021:1-14. [PMID: 33190607 DOI: 10.1080/00140139.2020.1810326_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
Many studies have measured stature change arising from loads imposed on the spine during sitting. To improve stature recovery, it is important to stabilise the lumbar spine and compensate forces from the upper body. The abdominal drawing-in maneuver (ADIM) technique has been found to mainly activate deep trunk muscles. The purpose of this study was to determine whether activation of deep trunk muscles by the ADIM technique could immediately improve stature recovery during prolonged sitting. Twenty-four patients with chronic low back pain (CLBP) were randomly allocated into different orders of experimental conditions: control (sitting without ADIM technique) and intervention conditions (sitting with ADIM technique). The latter condition required participants to complete ADIM technique for 1 min and repeat it three times throughout 41 min prolonged sitting time. Stature recovery was improved by 3.292 mm in the intervention condition compared with control condition (p-value = 0.001). Our finding demonstrated that ADIM technique improved stature recovery. Practitioner Summary: Prolonged sitting seemingly harms sedentary workers' health, particularly affecting the lower back. Activation of deep trunk muscles using abdominal drawing-in maneuver technique can promote spinal recovery. Clinicians can teach abdominal drawing-in maneuver technique to activate deep trunk muscles in chronic low back pain, thereby promoting self-management of seated stature recovery. Abbrevations: ADIM: abdominal drawing-in maneuver; RA: rectus abdominis; ICLT: iliocostalis lumborum pars thoracis; LM: lumbar multifidus; TrA: transversus abdominis; IO: internal oblique; CLBP: chronic low back pain; LBP: low back pain; RMDQ: Roland Morris disability questionnaire; NRS: numerical rating scale.
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Affiliation(s)
- Pongsatorn Saiklang
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rungthip Puntumetakul
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Manida Swangnetr Neubert
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Department of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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The effects of axial loading on the morphometric and T 2 characteristics of lumbar discs in relation to disc degeneration. Clin Biomech (Bristol, Avon) 2021; 83:105291. [PMID: 33596534 DOI: 10.1016/j.clinbiomech.2021.105291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Intervertebral disc degeneration affects the morphology, biomechanics and biochemistry of the disc. The study aimed to compare the effects of compression and traction on lumbar discs measurements in relation to degeneration. METHODS Thirty-five volunteers (30 (SD 11) yrs.) with and without chronic back pain rested supine 15 min before an unloaded T2-mapping MRI, were then loaded 20 min with 50% body weight with imaging during the last 5 min, and then repeated this process under traction. For lumbar discs, height, angle, width, mean-T2, and T2-weighted centroid locations were calculated. A repeated measure ANCOVA and Cohen's d compared loading conditions. Relations between measurement changes between conditions and degeneration assessed by Pfirrmann ratings were examined graphically. FINDINGS From compression to traction, we observed significant: decrease in L1-2 mean-T2 (Effect size = -0.35); inferior and posterior shift in L4-5 (0.4, 0.14) and L5-S1 (0.25, 0.33) T2-weighted centroid. From unloaded to compression, we observed a significant: increase in L5-S1 width (Effect Size = 0.22); anterior shift in L1-2 T2-weighted centroid (0.39); and L3-4 (mean 2.1°) and L4-5 (1.8°) extension angle. More degeneration was graphically related with larger changes from Compression to Traction (more superior and, anterior position of the T2-weighted centroid, increased height, reduced extension of segmental angle) and from Unloaded to Compression larger changes in inferior displacement of the T2-weighted centroid, decrease in height) but less anterior displacement of the centroid and less change in segmental angles. INTERPRETATION The largest loading responses were at lower levels, generally with more degeneration. T2-weighted centroid locations, angle and disc height detected the largest loading response.
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Saiklang P, Puntumetakul R, Swangnetr Neubert M, Boucaut R. The immediate effect of the abdominal drawing-in maneuver technique on stature change in seated sedentary workers with chronic low back pain. ERGONOMICS 2021; 64:55-68. [PMID: 32799753 DOI: 10.1080/00140139.2020.1810326] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
Many studies have measured stature change arising from loads imposed on the spine during sitting. To improve stature recovery, it is important to stabilise the lumbar spine and compensate forces from the upper body. The abdominal drawing-in maneuver (ADIM) technique has been found to mainly activate deep trunk muscles. The purpose of this study was to determine whether activation of deep trunk muscles by the ADIM technique could immediately improve stature recovery during prolonged sitting. Twenty-four patients with chronic low back pain (CLBP) were randomly allocated into different orders of experimental conditions: control (sitting without ADIM technique) and intervention conditions (sitting with ADIM technique). The latter condition required participants to complete ADIM technique for 1 min and repeat it three times throughout 41 min prolonged sitting time. Stature recovery was improved by 3.292 mm in the intervention condition compared with control condition (p-value = 0.001). Our finding demonstrated that ADIM technique improved stature recovery. Practitioner Summary: Prolonged sitting seemingly harms sedentary workers' health, particularly affecting the lower back. Activation of deep trunk muscles using abdominal drawing-in maneuver technique can promote spinal recovery. Clinicians can teach abdominal drawing-in maneuver technique to activate deep trunk muscles in chronic low back pain, thereby promoting self-management of seated stature recovery. Abbrevations: ADIM: abdominal drawing-in maneuver; RA: rectus abdominis; ICLT: iliocostalis lumborum pars thoracis; LM: lumbar multifidus; TrA: transversus abdominis; IO: internal oblique; CLBP: chronic low back pain; LBP: low back pain; RMDQ: Roland Morris disability questionnaire; NRS: numerical rating scale.
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Affiliation(s)
- Pongsatorn Saiklang
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rungthip Puntumetakul
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Manida Swangnetr Neubert
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Department of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Feki F, Taktak R, Kandil K, Derrouiche A, Moulart M, Haddar N, Zaïri F, Zaïri F. How Osmoviscoelastic Coupling Affects Recovery of Cyclically Compressed Intervertebral Disc. Spine (Phila Pa 1976) 2020; 45:E1376-E1385. [PMID: 33031252 DOI: 10.1097/brs.0000000000003593] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Osmoviscoelastic behavior of cyclically loaded cervical intervertebral disc. OBJECTIVE The aim of this study was to evaluate in vitro the effects of physiologic compressive cyclic loading on the viscoelastic properties of cervical intervertebral disc and, examine how the osmoviscoelastic coupling affects time-dependent recovery of these properties following a long period of unloading. SUMMARY OF BACKGROUND DATA The human neck supports repetitive loadings during daily activities and recovery of disc mechanics is essential for normal mechanical function. However, the response of cervical intervertebral disc to cyclic loading is still not very well defined. Moreover, how loading history conditions could affect the time-dependent recovery is still unclear. METHODS Ten thousand cycles of compressive loading, with different magnitudes and saline concentrations of the surrounding fluid bath, are applied to 8 motion segments (composed by 2 adjacent vertebrae and the intervening disc) extracted from the cervical spines of mature sheep. Subsequently, specimens are hydrated during 18 hours of unloading. The viscoelastic disc responses, after cyclic loading and recovery phase, are characterized by relaxation tests. RESULTS Viscoelastic behaviors are significantly altered following large number of cyclic loads. Moreover, after 18-hour recovery period in saline solution at reference concentration (0.15 mol/L), relaxation behaviors were fully restored. Nonetheless, full recovery is not obtained whether the concentration of the surrounding fluid, that is, hypo-, iso-, or hyper-osmotic conditions. CONCLUSION Cyclic loading effects and full recovery of viscoelastic behavior after hydration at iso-osmotic condition (0.15 mol/L) are governed by osmotic attraction of fluid content in the disc due to imbalance between the external load and the swelling pressure of the disc. After removal of the load, the disc recovers its viscoelastic properties following period of rest. Nevertheless, the viscoelastic recovery is a chemically activated process and its dependency on saline concentration is governed by fluid flow due to imbalance of ions between the disc tissues and the surrounding fluid. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Faten Feki
- ENIS, Materials Engineering and Environment Laboratory (LGME), Sfax, Tunisia
| | - Rym Taktak
- ENIS, Materials Engineering and Environment Laboratory (LGME), Sfax, Tunisia
| | - Karim Kandil
- Lille University, Civil Engineering and geo-Environmental Laboratory (ULR 4515 LGCgE), Lille, France
| | - Amil Derrouiche
- Lille University, Civil Engineering and geo-Environmental Laboratory (ULR 4515 LGCgE), Lille, France
| | | | - Nader Haddar
- ENIS, Materials Engineering and Environment Laboratory (LGME), Sfax, Tunisia
| | - Fahmi Zaïri
- Lille University, Civil Engineering and geo-Environmental Laboratory (ULR 4515 LGCgE), Lille, France
| | - Fahed Zaïri
- Ramsay Générale de Santé, Hôpital privé Le Bois, Lille, France
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16
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Castro APG, Alves JL. Numerical implementation of an osmo-poro-visco-hyperelastic finite element solver: application to the intervertebral disc. Comput Methods Biomech Biomed Engin 2020; 24:538-550. [PMID: 33111576 DOI: 10.1080/10255842.2020.1839059] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This work deals with the finite element (FE) implementation of a biphasic poroelastic formulation specifically developed to address the intricate behaviour of the Intervertebral Disc (IVD) and other highly hydrated soft tissues. This formulation is implemented in custom FE solver V-Biomech, being the validation performed with a lumbar IVD model, which was compared against the analogous FE model of Williams et al. and the experiments of Tyrrell et al. Good agreement with these benchmarks was achieved, meaning that V-Biomech and its novel poroelastic formulation are a viable alternative for simulation of biphasic soft tissues.
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Affiliation(s)
- A P G Castro
- IDMEC - Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - J L Alves
- CMEMs, Department of Mechanical Engineering, Universidade do Minho, Guimarães, Portugal
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17
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The two Poisson’s ratios in annulus fibrosus: relation with the osmo-inelastic features. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42558-019-0016-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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18
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Xing Y, Zhang P, Zhang Y, Holzer L, Xiao L, He Y, Majumdar R, Huo J, Yu X, Ramasubramanian MK, Jin L, Wang Y, Li X, Oberholzer J. A multi-throughput mechanical loading system for mouse intervertebral disc. J Mech Behav Biomed Mater 2020; 105:103636. [PMID: 32279855 DOI: 10.1016/j.jmbbm.2020.103636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/01/2022]
Abstract
Mechanical loading plays an important role in maintaining disc health and function, and in particular, excessive mechanical loading has been identified as one of major reasons of disc degeneration. Intervertebral disc organ culture serves as a valuable tool to study disc biology/pathology. In this study, we report the development and validation of a new mouse disc organ culture system by dynamically applying compression loading in a customized micro-culture device tailored for mouse lumbar discs. Precise axial compression force was delivered by a computer-controlled system consisting of a robust micromechanical linear actuator, a force sensitive resistor, and a precision micro-stepping machinery. Customized PDMS-based loading chambers allowed simultaneous loading of six discs per regimen, which streamlined the workflow to reach sufficient statistic power. The detrimental loading regimen of mouse lumbar discs (0.5 MPa of axial compression at 1Hz for 7 days) was demonstrated through live-dead assay, histology, and fluorescence probe based collagen staining. In addition, various mechanical compression profiles were simulated using different materials and geometry designs, potentiating for more sophisticated loading protocols. In summary, we developed a new mechanical loading system for dynamic axial compression of mouse discs, which created a unique avenue to study disc pathogenesis with enriched mouse species-related resources, and complemented the existing spectrum of bioreactor systems predominately for discs of human and large animals.
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Affiliation(s)
- Yuan Xing
- Department of Surgery, University of Virginia, 345 Crispell Drive, Charlottesville, VA, 22908, United States
| | - Pu Zhang
- Department of Mechanical and Aerospace Engineering, University of Virginia, 122 Engineer's Way, Charlottesville, VA, 22904, United States
| | - Yangpu Zhang
- Department of Orthopaedic Surgery, University of Virginia, 135 Hospital Drive, Charlottesville, VA, 22908, United States; Current Address: Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Chaoyang District, Beijing, China
| | - Liam Holzer
- Department of Biomedical Engineering, Purdue University, 206 S Martin Jischke Dr, West Lafayette, IN, 47907, United States
| | - Li Xiao
- Department of Orthopaedic Surgery, University of Virginia, 135 Hospital Drive, Charlottesville, VA, 22908, United States
| | - Yi He
- Department of Surgery, University of Virginia, 345 Crispell Drive, Charlottesville, VA, 22908, United States
| | - Rahul Majumdar
- Department of Orthopaedic Surgery, University of Virginia, 135 Hospital Drive, Charlottesville, VA, 22908, United States
| | - Jianzhong Huo
- Department of Orthopaedic Surgery, University of Virginia, 135 Hospital Drive, Charlottesville, VA, 22908, United States; Current Address: Department of Orthopaedic Surgery, Shanxi DaYi Hospital, 99 Long Road, Taiyuan, Shanxi, 030032, China
| | - Xiaoyu Yu
- Department of Surgery, University of Virginia, 345 Crispell Drive, Charlottesville, VA, 22908, United States
| | - Melur K Ramasubramanian
- Department of Mechanical and Aerospace Engineering, University of Virginia, 122 Engineer's Way, Charlottesville, VA, 22904, United States
| | - Li Jin
- Department of Orthopaedic Surgery, University of Virginia, 135 Hospital Drive, Charlottesville, VA, 22908, United States
| | - Yong Wang
- Department of Surgery, University of Virginia, 345 Crispell Drive, Charlottesville, VA, 22908, United States
| | - Xudong Li
- Department of Orthopaedic Surgery, University of Virginia, 135 Hospital Drive, Charlottesville, VA, 22908, United States.
| | - Jose Oberholzer
- Department of Surgery, University of Virginia, 345 Crispell Drive, Charlottesville, VA, 22908, United States.
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Saiklang P, Puntumetakul R, Swangnetr Neubert M, Boucaut R. Effect of time of day on height loss response variability in asymptomatic participants on two consecutive days. ERGONOMICS 2019; 62:1542-1550. [PMID: 31526175 DOI: 10.1080/00140139.2019.1663941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
Ergonomists measure height loss in relation to loads imposed on the spine. It is difficult to interpret whether height loss responses recorded on different days are accurate due to natural daily fluctuations in height loss and measurement variability. The objective of this research was to investigate whether the variability of height loss in the sitting position is affected by time of day and to analyse day-to-day variability in asymptomatic participants. Fifty asymptomatic participants attended two sessions (morning and afternoon) of stadiometry testing on four separate days. The results showed that a variability of height loss response changes in excess of 0.886 mm in morning and 1.128 mm in afternoon between days indicates that an intervention itself has influenced height loss. Future investigations on height loss in sitting should take these results into consideration to confidently state that an intervention has influenced height loss response at each time of day. Practitioner summary: Daily fluctuation creates difficulties when interpreting whether height losses recorded on different days and times are intervention related. Seated stadiometry measures on different days and times of day demonstrated specific levels of natural variation. Changes above 0.886 mm (morning) and 1.128 mm (afternoon) can be attributed to intervention effects. Abbreviations: LBP: low back pain; SEM: standard error of measurement; MeanSDs: means of standard deviations.
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Affiliation(s)
- Pongsatorn Saiklang
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen , Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen , Thailand
| | - Rungthip Puntumetakul
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen , Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen , Thailand
| | - Manida Swangnetr Neubert
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen , Thailand
- Department of Production Technology, Faculty of Technology, Khon Kaen University , Khon Kaen , Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence, University of South Australia , Adelaide , Australia
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20
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A chemo-mechanical model for osmo-inelastic effects in the annulus fibrosus. Biomech Model Mechanobiol 2019; 18:1773-1790. [DOI: 10.1007/s10237-019-01176-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
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21
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Huang YC, Hu Y, Li Z, Luk KDK. Biomaterials for intervertebral disc regeneration: Current status and looming challenges. J Tissue Eng Regen Med 2018; 12:2188-2202. [PMID: 30095863 DOI: 10.1002/term.2750] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/21/2018] [Accepted: 07/13/2018] [Indexed: 12/19/2022]
Abstract
A biomaterial-based strategy is employed to regenerate the degenerated intervertebral disc, which is considered a major generator of neck and back pain. Although encouraging enhancements in the anatomy and kinematics of the degenerative disc have been gained by biomaterials with various formulations in animals, the number of biomaterials tested in humans is rare. At present, most studies that involve the use of newly developed biomaterials focus on regeneration of the degenerative disc, but not pain relief. In this review, we summarise the current state of the art in the field of biomaterial-based regeneration or repair for the nucleus pulposus, annulus fibrosus, and total disc transplantation in animals and humans, and we then provide essential suggestions for the development and clinical translation of biomaterials for disc regeneration. It is important for researchers to consider the commonly neglected issues instead of concentrating solely on biomaterial development and fabrication.
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Affiliation(s)
- Yong-Can Huang
- Shenzhen Engineering Laboratory of Orthopaedic Regenerative Technologies, Orthopaedic Research Center, Peking University Shenzhen Hospital, Shenzhen, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China.,Shenzhen Key Laboratory of Spine Surgery, Department of Spine Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yong Hu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Zhen Li
- AO Research Institute Davos, Davos, Switzerland
| | - Keith D K Luk
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
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22
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Velísková P, Bashkuev M, Shirazi-Adl A, Schmidt H. Computational study of the role of fluid content and flow on the lumbar disc response in cyclic compression: Replication of in vitro and in vivo conditions. J Biomech 2018; 70:16-25. [DOI: 10.1016/j.jbiomech.2017.10.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/18/2017] [Accepted: 10/27/2017] [Indexed: 10/18/2022]
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23
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Zvicer J, Obradovic B. Bioreactors with hydrostatic pressures imitating physiological environments in intervertebral discs. J Tissue Eng Regen Med 2017; 12:529-545. [PMID: 28763577 DOI: 10.1002/term.2533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 06/27/2017] [Accepted: 07/27/2017] [Indexed: 12/28/2022]
Abstract
Intervertebral discs are normally exposed to a variety of loads and stresses but hydrostatic pressure (HP) could be the main biosignal for chondrogenic cell differentiation and maintenance of this tissue. Although there are simple approaches to intermittently expose cell cultures to HP in separate material testing devices, utilization of biomimetic bioreactors aiming to provide in vitro conditions mimicking those found in vivo, attracts special attention. However, design of such bioreactors is complex due to the requirement of high HP magnitudes (up to 3 MPa) applied in different regimes mimicking pressures arising in intervertebral disc during normal daily activities. Furthermore, efficient mass transfer has to be facilitated to cells within 3D scaffolds, and the engineering challenges include avoidance or removal of gas bubbles in the culture medium before pressurization as well as selection of appropriate, biocompatible construction materials and maintenance of sterility during cultivation. Here, we review approaches to induce HP in 2D and 3D cell cultures categorized into 5 groups: (I) discontinuous systems with direct pressurization of the cultivation medium by a piston, (II) discontinuous systems with indirect pressurization by a compression fluid, (III) continuous systems with direct pressurization of the cultivation medium, static culture, (IV) continuous systems with culture perfusion, and (V) systems applying HP in conjunction with other physical signals. Although the complexity is increasing as additional features are added to the systems, the need to understand HP effects on cells and tissues in a physiologically relevant, yet precisely controlled, environment together with current technological advancements are leading towards innovative bioreactor solutions.
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Affiliation(s)
- Jovana Zvicer
- Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia
| | - Bojana Obradovic
- Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia
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