Streaming potential of human lumbar anulus fibrosus is anisotropic and affected by disc degeneration

A quadriphasic mechanical model of the human dermis

The present study investigates the multiphasic nature of the mechanical behavior of human dermis. Motivated by experimental observations and by consideration of its composition, a quadriphasic model of the dermis is proposed, distinguishing solid matrix components, interstitial fluid and charged constituents moving within the fluid, i.e., anions and cations. Compression and tensile experiments with and without change of osmolarity of the bath are performed to characterize the chemo-mechanical coupling in the dermis. Model parameters are determined through inverse analysis. The computations predict a dominant role of the permeability in the determination of the temporal evolution of the mechanical response of the tissue. In line with the previous studies on other tissues, the analysis shows that an ideal model based on Donnan's equilibrium overestimates the osmotic pressure in skin for the case of very dilute solutions. The quadriphasic model is applied to predict changes in dermal cell environment and therefore alterations in what is called the "mechanome," associated with skin stretch. The simulations indicate that skin deformation causes a variation in several local variables, including in particular the electric field associated with a deformation-induced non-homogeneous distribution of fixed charges.

A new look at osteoarthritis: Threshold potentials and an analogy to hypocalcemia

Cartilage is a tissue that consist of very few cells embedded in a highly negatively charged extracellular matrix (ECM). This tissue is dealing with several electrical potentials which have been shown to control the production of ECM. Cartilage is present at joints and is constantly prone to degradation. Failing to repair the damage will result in the occurrence of osteoarthritis (OA). This perspective aims to link biophysical insights with biomolecular research in order to provide an alternative view on the possible causes of OA. Firstly, we hypothesize the existence of a threshold potential, which should be reached in order to initiate repair but if not met, unrepaired damage will evolve to OA. Measurements of the magnitude of this threshold electrical potential would be a helpful diagnostic tool. Secondly, since electrical potential alterations can induce chondrocytes to synthesize ECM, a cellular sensor must be present. We here propose an analogy to the hypocalcemia ‘unshielding’ situation to comprehend electrical potential generation and explore possible sensing mechanisms translating the electrical message into cellular responses. A better understanding of the cellular voltage sensors and down-stream signalling mechanisms may lead to the development of novel treatments for cartilage regeneration.

Inhibition of toll-like receptor 4 protects against inflammation-induced mechanobiological alterations to intervertebral disc cells

Intervertebral disc (IVD) degeneration is associated with elevated levels of inflammatory cytokines implicated in disease aetiology and matrix degradation. Toll-like receptor-4 (TLR4) has been shown to participate in the inflammatory responses of the nucleus pulposus (NP) and its levels are upregulated in disc degeneration. Activation of TLR4 in NP cells leads to significant, persistent changes in cell biophysical properties, including hydraulic permeability and osmotically active water content, as well as alterations to the actin cytoskeleton. The study hypothesis was that inflammation-induced changes to cellular biomechanical properties and actin cytoskeleton of NP cells could be prevented by inhibiting TLR4 signalling. Isolated NP cells from bovine discs were treated with lipopolysaccharide (LPS), the best studied TLR4 agonist, with or without treatment with the TLR4 inhibitor TAK-242. Cellular volume regulation responses to step osmotic loading were measured and the transient volume-response was captured by time-lapse microscopy. Volume-responses were analysed using mixture theory framework to investigate hydraulic permeability and osmotically active intracellular water content. Hydraulic permeability and cell radius were significantly increased with LPS treatment and these changes were blocked in cells treated with TAK-242. LPS-induced remodelling of cortical actin and IL-6 upregulation were also mitigated by TAK-242 treatment. These findings indicated that TLR4 signalling participated in NP cell biophysical regulation and may be an important target for mitigating altered cell responses observed in IVD inflammation and degeneration.

The strain-generated electrical potential in cartilaginous tissues: a role for piezoelectricity

The strain-generated potential (SGP) is a well-established mechanism in cartilaginous tissues whereby mechanical forces generate electrical potentials. In articular cartilage (AC) and the intervertebral disc (IVD), studies on the SGP have focused on fluid- and ionic-driven effects, namely Donnan, diffusion and streaming potentials. However, recent evidence has indicated a direct coupling between strain and electrical potential. Piezoelectricity is one such mechanism whereby deformation of most biological structures, like collagen, can directly generate an electrical potential. In this review, the SGP in AC and the IVD will be revisited in light of piezoelectricity and mechanotransduction. While the evidence base for physiologically significant piezoelectric responses in tissue is lacking, difficulties in quantifying the physiological response and imperfect measurement techniques may have underestimated the property. Hindering our understanding of the SGP further, numerical models to-date have negated ferroelectric effects in the SGP and have utilised classic Donnan theory that, as evidence argues, may be oversimplified. Moreover, changes in the SGP with degeneration due to an altered extracellular matrix (ECM) indicate that the significance of ionic-driven mechanisms may diminish relative to the piezoelectric response. The SGP, and these mechanisms behind it, are finally discussed in relation to the cell response.

Effect of intervertebral disc degeneration on mechanical and electric signals at the interface between disc and vertebra

Intervertebral disc (IVD) degeneration is significantly correlated with the changes in structure and material properties of adjacent vertebral bone, possibly through mechanical and electrical interactions. However, the mechanisms underlying the alteration of the mechanical and electrical environment at the disc-vertebra interface related with disc degeneration have not been well studied. The objective of this study was to numerically investigate the long-term distributions of mechanical and electrical signals on the disc-vertebra interface with disc degeneration. A three-dimensional finite element model of a human lumbar IVD was used to study the mechanical and electric signals at the interface between disc and vertebral body. The disc degeneration was simulated by reducing the nutrition levels on the nucleus pulposus (NP)-vertebra interface and on the annulus fibrosus (AF) periphery to 30% and 60% of its normal values, respectively. In the simulation, the total external mechanical load applied to the disc-vertebra segment was assumed unchanged during disc degeneration. The simulation results showed that the compressive stress of solid matrix changed by up to ~37 kPa on the NP-vertebra interface, while it increased by up to ~32 kPa on the AF-vertebra interface. The shear stress increased by up to ~37 kPa with disc degeneration. The absolute value of the electric potential on the disc-vertebra interface of the disc slightly decreased with the disc degeneration (~0.5 mV). The knowledge of these spatial and temporal variations of the mechanical stresses and electric potential on the disc-vertebra interface is important for understanding the vertebrae adaptation and remodeling during disc degeneration.

Quantifying Baseline Fixed Charge Density in Healthy Human Cartilage Endplate: A Two-point Electrical Conductivity Method

STUDY DESIGN

Regional measurements of fixed charge densities (FCDs) of healthy human cartilage endplate (CEP) using a two-point electrical conductivity approach.

OBJECTIVE

The aim of this study was to determine the FCDs at four different regions (central, lateral, anterior, and posterior) of human CEP, and correlate the FCDs with tissue biochemical composition.

SUMMARY OF BACKGROUND DATA

The CEP, a thin layer of hyaline cartilage on the cranial and caudal surfaces of the intervertebral disc, plays an irreplaceable role in maintaining the unique physiological mechano-electrochemical environment inside the disc. FCD, arising from the carboxyl and sulfate groups of the glycosaminoglycans (GAG) in the extracellular matrix of the disc, is a key regulator of the disc ionic and osmotic environment through physicochemical and electrokinetic effects. Although FCDs in the annulus fibrosus (AF) and nucleus pulposus (NP) have been reported, quantitative baseline FCD in healthy human CEP has not been reported.

METHODS

CEP specimens were regionally isolated from human lumbar spines. FCD and ion diffusivity were concurrently investigated using a two-point electrical conductivity method. Biochemical assays were used to quantify regional GAG and water content.

RESULTS

FCD in healthy human CEP was region-dependent, with FCD lowest in the lateral region (P = 0.044). Cross-region FCD was 30% to 60% smaller than FCD in NP, but similar to the AF and articular cartilage (AC). CEP FCD (average: 0.12 ± 0.03 mEq/g wet tissue) was correlated with GAG content (average: 31.24 ± 5.06 μg/mg wet tissue) (P = 0.005). In addition, the cross-region ion diffusivity in healthy CEP (2.97 ± 1.00 × 10 cm/s) was much smaller than the AF and NP.

CONCLUSION

Healthy human CEP acts as a biomechanical interface, distributing loads between the bony vertebral body and soft disc tissues and as a gateway impeding rapid solute diffusion through the disc.

LEVEL OF EVIDENCE

N/A.

MR Elastography-derived Stiffness: A Biomarker for Intervertebral Disc Degeneration

Purpose To determine the repeatability of magnetic resonance (MR) elastography-derived shear stiffness measurements of the intervertebral disc (IVD) taken throughout the day and their relationship with IVD degeneration and subject age. Materials and Methods In a cross-sectional study, in vivo lumbar MR elastography was performed once in the morning and once in the afternoon in 47 subjects without current low back pain (IVDs = 230; age range, 20-71 years) after obtaining written consent under approval of the institutional review board. The Pfirrmann degeneration grade and MR elastography-derived shear stiffness of the nucleus pulposus and annulus fibrosus regions of all lumbar IVDs were assessed by means of principal frequency analysis. One-way analysis of variance, paired t tests, concordance and Bland-Altman tests, and Pearson correlations were used to evaluate degeneration, diurnal changes, repeatability, and age effects, respectively. Results There were no significant differences between morning and afternoon shear stiffness across all levels and there was very good technical repeatability between the morning and afternoon imaging results for both nucleus pulposus (R = 0.92) and annulus fibrosus (R = 0.83) regions. There was a significant increase in both nucleus pulposus and annulus fibrosus MR elastography-derived shear stiffness with increasing Pfirrmann degeneration grade (nucleus pulposus grade 1, 12.5 kPa ± 1.3; grade 5, 16.5 kPa ± 2.1; annulus fibrosus grade 1, 90.4 kPa ± 9.3; grade 5, 120.1 kPa ± 15.4), and there were weak correlations between shear stiffness and age across all levels (R ≤ 0.32). Conclusion Our results demonstrate that MR elastography-derived shear stiffness measurements are highly repeatable, weakly correlate with age, and increase with advancing IVD degeneration. These results suggest that MR elastography-derived shear stiffness may provide an objective biomarker of the IVD degeneration process. ^© RSNA, 2017 Online supplemental material is available for this article.

Region and strain-dependent diffusivities of glucose and lactate in healthy human cartilage endplate

The cartilage endplate (CEP) is implicated as the main pathway of nutrient supply to the healthy human intervertebral disc (IVD). In this study, the diffusivities of nutrient/metabolite solutes in healthy CEP were assessed, and further correlated with tissue biochemical composition and structure. The CEPs from non-degenerated human IVD were divided into four regions: central, lateral, anterior, and posterior. The diffusivities of glucose and lactate were measured with a custom diffusion cell apparatus under 0%, 10%, and 20% compressive strains. Biochemical assays were conducted to quantify the water and glycosaminoglycan (GAG) contents. The Safranin-O and Ehrlich׳s hematoxylin and eosin staining and scanning electron microscopy (SEM) were performed to reveal the tissue structure of the CEP. Average diffusivities of glucose and lactate in healthy CEP were 2.68±0.93×10^-7cm²/s and 4.52±1.47×10^-7cm²/s, respectively. Solute diffusivities were region-dependent (p<0.0001) with the highest values in the central region, and mechanical strains impeded solute diffusion in the CEP (p<0.0001). The solute diffusivities were significantly correlated with the tissue porosities (glucose: p<0.0001, r=0.581; lactate: p<0.0001, r=0.534). Histological and SEM studies further revealed that the collagen fibers in healthy CEP are more compacted than those in the nucleus pulposus (NP) and annulus fibrosus (AF) and show no clear orientation. Compared to human AF and NP, much smaller solute diffusivities in human CEP suggested that it acts as a gateway for solute diffusion through the disc, maintaining the balance of nutritional environment in healthy human disc under mechanical loading and preventing the progression of disc degeneration.

Matrix fixed charge density modulates exudate concentration during cartilage compression

Electrolyte filtration arises due to the presence of fixed charges in cartilage extracellular matrix glycosaminoglycans (GAGs). Commonly assumed negligible, it can be important for design and interpretation of streaming potential measurements and modeling assumptions. To quantify the scale of this phenomenon, chloride ion concentration in exudate of compressed cartilage was measured by Mohr's titration and explant GAG content was colorimetrically assayed. Pilot studies indicated that an appropriate strain rate for experiments was 8 × 10(-3) s(-1) to eliminate concerns of exudate evaporation and explant damage (at low and high strain rates, respectively). Exudate chloride concentration of explants equilibrated in 1× PBS was significantly (p < 0.05) lower than the bath chloride concentration at strains of 37.5, 50, and 62.5%, with clear dependence on strain magnitude. Exudate chloride concentration was also significantly lower than that of the bath when 50% strain was applied after equilibration in 0.5, 1, and 2× PBS, with a trend for an increase in this relative difference with decreasing bath concentration (p = 0.065 between 0.5 and 2× PBS). Decreasing exudate chloride concentration correlated negatively with increasing postcompression GAG concentration. No difference between exudate chloride concentration and bath chloride concentration was ever observed for compression of uncharged agarose gel controls. Findings show that exudate from compressed cartilage is dilute relative to the bath due to the presence of matrix fixed charges, and this difference can generate diffusion potentials external to the explant, which may affect streaming potential measurements particularly under conditions of low strain rates and high strains.

Role of biomechanics in intervertebral disc degeneration and regenerative therapies: what needs repairing in the disc and what are promising biomaterials for its repair?

BACKGROUND CONTEXT

Degeneration and injuries of the intervertebral disc (IVD) result in large alterations in biomechanical behaviors. Repair strategies using biomaterials can be optimized based on the biomechanical and biological requirements of the IVD.

PURPOSE

To review the present literature on the effects of degeneration, simulated degeneration, and injury on biomechanics of the IVD, with special attention paid to needle puncture injuries, which are a pathway for diagnostics and regenerative therapies and the promising biomaterials for disc repair with a focus on how those biomaterials may promote biomechanical repair.

STUDY DESIGN

A narrative review to evaluate the role of biomechanics on disc degeneration and regenerative therapies with a focus on what biomechanical properties need to be repaired and how to evaluate and accomplish such repairs using biomaterials. Model systems for the screening of such repair strategies are also briefly described.

METHODS

Articles were selected from two main PubMed searches using keywords: intervertebral AND biomechanics (1,823 articles) and intervertebral AND biomaterials (361 articles). Additional keywords (injury, needle puncture, nucleus pressurization, biomaterials, hydrogel, sealant, tissue engineering) were used to narrow the articles down to the topics most relevant to this review.

RESULTS

Degeneration and acute disc injuries have the capacity to influence nucleus pulposus (NP) pressurization and annulus fibrosus (AF) integrity, which are necessary for an effective disc function and, therefore, require repair. Needle injection injuries are of particular clinical relevance with the potential to influence disc biomechanics, cellularity, and metabolism, yet these effects are localized or small and more research is required to evaluate and reduce the potential clinical morbidity using such techniques. NP replacement strategies, such as hydrogels, are required to restore the NP pressurization or the lost volume. AF repair strategies including cross-linked hydrogels, fibrous composites, and sealants offer promise for regenerative therapies to restore AF integrity. Tissue engineered IVD structures, as a single implantable construct, may promote greater tissue integration due to the improved repair capacity of the vertebral bone.

CONCLUSIONS

IVD height, neutral zone characteristics, and torsional biomechanics are sensitive to specific alterations in the NP pressurization and AF integrity and must be addressed for an effective functional repair. Synthetic and natural biomaterials offer promise for NP replacement, AF repair, as an AF sealant, or whole disc replacement. Meeting mechanical and biological compatibilities are necessary for the efficacy and longevity of the repair.

Computational aspects in mechanical modeling of the articular cartilage tissue

This review focuses on the modeling of articular cartilage (at the tissue level), chondrocyte mechanobiology (at the cell level) and a combination of both in a multiscale computation scheme. The primary objective is to evaluate the advantages and disadvantages of conventional models implemented to study the mechanics of the articular cartilage tissue and chondrocytes. From monophasic material models as the simplest form to more complicated multiscale theories, these approaches have been frequently used to model articular cartilage and have contributed significantly to modeling joint mechanics, addressing and resolving numerous issues regarding cartilage mechanics and function. It should be noted that attentiveness is important when using different modeling approaches, as the choice of the model limits the applications available. In this review, we discuss the conventional models applicable to some of the mechanical aspects of articular cartilage such as lubrication, swelling pressure and chondrocyte mechanics and address some of the issues associated with the current modeling approaches. We then suggest future pathways for a more realistic modeling strategy as applied for the simulation of the mechanics of the cartilage tissue using multiscale and parallelized finite element method.

Cell viability in intervertebral disc under various nutritional and dynamic loading conditions: 3d finite element analysis

In this study, a new cell density model was developed and incorporated into the formulation of the mechano-electrochemical mixture theory to investigate the effects of deprivation of nutrition supply at boundary source, degeneration, and dynamic loading on the cell viability of intervertebral disc (IVD) using finite element methods. The deprivation of nutrition supply at boundary source was simulated by reduction in nutrition level at CEP and AF boundaries. Cases with 100%, 75%, 60%, 50% and 30% of normal nutrition level at both CEP and AF boundaries were modeled. Unconfined axial sinusoidal dynamic compressions with different combinations of amplitude (u=10%± 2.5%, ± 5%) and frequency (f=1, 10, 20 cycle/day) were applied. Degenerated IVD was modeled with altered material properties. Cell density decreased substantially with reduction of nutrition level at boundaries. Cell death was initiated primarily near the NP-AF interface on the mid-plane. Dynamic loading did not result in a change in the cell density in non-degenerated IVD, since glucose levels did not fall below the minimum value for cell survival; in degenerated IVDs, we found that increasing frequency and amplitude both resulted in higher cell density, because dynamic compression facilitates the diffusion of nutrients and thus increases the nutrition level around IVD cells. The novel computational model can be used to quantitatively predict both when and where cells start to die within the IVD under various kinds of nutritional and mechanical conditions.

Evidence of interlinks between bioelectromagnetics and biomechanics: from biophysics to medical physics

A vast literature on electromagnetic and mechanical bioeffects at the bone and soft tissue level, as well as at the cellular level (osteoblasts, osteoclasts, keratinocytes, fibroblasts, chondrocytes, nerve cells, endothelial and muscle cells) has been reviewed and analysed in order to show the evident connections between both types of physical energies. Moreover, an intimate link between the two is suggested by transduction phenomena (electromagnetic-acoustic transduction and its reverse) occurring in living matter, as a sound biophysical literature has demonstrated. However, electromagnetic and mechanical signals are not always interchangeable, depending on their respective intensity. Calculations are reported in order to show in which cases (read: for which values of electric field in V/m and of mechanical pressure in Pa) a given electromagnetic or mechanical bioeffect is only due to the directly impinging energy or even to the indirect transductional energy. The relevance of the treated item for the applications of medical physics to regenerative medicine is stressed.

Novel technique for online characterization of cartilaginous tissue properties

The goal of tissue engineering is to use substitutes to repair and restore organ function. Bioreactors are an indispensable tool for monitoring and controlling the unique environment for engineered constructs to grow. However, in order to determine the biochemical properties of engineered constructs, samples need to be destroyed. In this study, we developed a novel technique to nondestructively online-characterize the water content and fixed charge density of cartilaginous tissues. A new technique was developed to determine the tissue mechano-electrochemical properties nondestructively. Bovine knee articular cartilage and lumbar annulus fibrosus were used in this study to demonstrate that this technique could be used on different types of tissue. The results show that our newly developed method is capable of precisely predicting the water volume fraction (less than 3% disparity) and fixed charge density (less than 16.7% disparity) within cartilaginous tissues. This novel technique will help to design a new generation of bioreactors which are able to actively determine the essential properties of the engineered constructs, as well as regulate the local environment to achieve the optimal conditions for cultivating constructs.

Intervertebral disc properties: challenges for biodevices

Intervertebral disc biodevices that employ motion-preservation strategies (e.g., nucleus replacement, total disc replacement and posterior stabilization devices) are currently in use or in development. However, their long-term performance is unknown and only a small number of randomized controlled trials have been conducted. In this article, we discuss the following biodevices: interbody cages, nuclear pulposus replacements, total disc replacements and posterior dynamic stabilization devices, as well as future biological treatments. These biodevices restore some function to the motion segment; however, contrary to expectations, the risk of adjacent-level degeneration does not appear to have been reduced. The short-term challenge is to replicate the complex biomechanical function of the motion segment (e.g., biphasic, viscoelastic behavior and nonlinearity) to improve the quality of motion and minimize adjacent level problems, while ensuring biodevice longevity for the younger, more active patient. Biological strategies for regeneration and repair of disc tissue are being developed and these offer exciting opportunities (and challenges) for the longer term. Responsible introduction and rigorous assessment of these new technologies are required. In this article, we will describe the properties of the disc, explore biodevices currently in use for the surgical treatment of low back pain (with an emphasis on lumbar total disc replacement) and discuss future directions for biological treatments. Finally, we will assess the challenges ahead for the next generation of biodevices designed to replace the disc.

Relationship between streaming potential and compressive stress in bovine intervertebral tissue

The intervertebral disc is formed by the nucleus pulposus (NP) and annulus fibrosus (AF), and intervertebral tissue contains a large amount of negatively charged proteoglycan. When this tissue becomes deformed, a streaming potential is induced by liquid flow with positive ions. The anisotropic property of the AF tissue is caused by the structural anisotropy of the solid phase and the liquid phase flowing into the tissue with the streaming potential. This study investigated the relationship between the streaming potential and applied stress in bovine intervertebral tissue while focusing on the anisotropy and loading location. Column-shaped specimens, 5.5 mm in diameter and 3 mm thick, were prepared from the tissue of the AF, NP and the annulus-nucleus transition region (AN). The loading direction of each specimen was oriented in the spinal axial direction, as well as in the circumferential and radial directions of the spine considering the anisotropic properties of the AF tissue. The streaming potential changed linearly with stress in all specimens. The linear coefficients k(e) of the relationship between stress and streaming potential depended on the extracted positions. These coefficients were not affected by the anisotropy of the AF tissue. In addition, these coefficients were lower in AF than in NP specimens. Except in the NP specimen, the k(e) values were higher under faster compression rate conditions. In cyclic compression loading the streaming potential changed linearly with compressive stress, regardless of differences in the tissue and load frequency.

Three-dimensional finite element modeling of pericellular matrix and cell mechanics in the nucleus pulposus of the intervertebral disk based on in situ morphology

Nucleus pulposus (NP) cells of the intervertebral disk (IVD) have unique morphological characteristics and biologic responses to mechanical stimuli that may regulate maintenance and health of the IVD. NP cells reside as single cell, paired or multiple cells in a contiguous pericellular matrix (PCM), whose structure and properties may significantly influence cell and extracellular matrix mechanics. In this study, a computational model was developed to predict the stress-strain, fluid pressure and flow fields for cells and their surrounding PCM in the NP using three-dimensional (3D) finite element models based on the in situ morphology of cell-PCM regions of the mature rat NP, measured using confocal microscopy. Three-dimensional geometries of the extracellular matrix and representative cell-matrix units were used to construct 3D finite element models of the structures as isotropic and biphasic materials. In response to compressive strain of the extracellular matrix, NP cells and PCM regions were predicted to experience volumetric strains that were 1.9-3.7 and 1.4-2.1 times greater than the extracellular matrix, respectively. Volumetric and deviatoric strain concentrations were generally found at the cell/PCM interface, while von Mises stress concentrations were associated with the PCM/extracellular matrix interface. Cell-matrix units containing greater cell numbers were associated with higher peak cell strains and lower rates of fluid pressurization upon loading. These studies provide new model predictions for micromechanics of NP cells that can contribute to an understanding of mechanotransduction in the IVD and its changes with aging and degeneration.

Cellular mechanobiology of the intervertebral disc: new directions and approaches

The more we learn about the intervertebral disc (IVD), the more we come to appreciate the intricacies involved in transmission of forces through the ECM to the cell, and in the biological determinants of its response to mechanical stress. This review highlights recent developments in our knowledge of IVD physiology and examines their impact on cellular mechanobiology. Discussion centers around the continually evolving cellular and microstructural anatomy of the nucleus pulposus (NP) and the annulus fibrosus (AF) in response to complex stresses generated in support of axial load and spinal motion. Particular attention has been given to cells from the immature NP and the interlamellar AF, and assessment of their potential mechanobiologic contributions to the health and function of the IVD. In addition, several innovative approaches that have been brought to bear on studying the interplay between disc cells and their micromechanical environment are discussed. Techniques for "engineering" cellular function and technologies for fabricating more structurally defined biomaterial scaffolds have recently been employed in disc research. Such tools can be used to elucidate the biological and physical mechanisms by which different IVD cell populations are regulated by mechanical stress, and contribute to advancement of preventative and therapeutic measures.

A conductivity approach to measuring fixed charge density in intervertebral disc tissue

A new method for measuring the fixed charge density (FCD) in intervertebral disc (IVD) tissues employing a two-point electrical conductivity approach was developed. In this technique, the tissue is first confined and equilibrated in a potassium chloride (KCl) solution, and the tissue conductivity is then measured. This is then repeated with a second concentration of KCl solution. The FCD can be determined from the conductivity measurements. Using this method, the FCD values of bovine annulus fibrosus (AF) and nucleus pulposus (NP) tissues were determined to be 0.060 +/- 0.027 mEq/g wet tissue and 0.19 +/- 0.039 mEq/g wet tissue, respectively. The FCD of AF was significantly lower than that of NP tissue, similar to results in the literature for human IVD tissues. In order to verify the accuracy of the new method, the glycosaminoglycan (GAG) contents of the tissues were measured and used to estimate the tissue FCD. A strong correlation (R (2) = 0.84-0.87) was found to exist between FCD values measured and those estimated from GAG contents, indicating that the conductivity approach is a reliable technique for measuring the FCD of IVD tissues.

Spatially resolved streaming potentials of human intervertebral disk motion segments under dynamic axial compression

Intervertebral disk degeneration results in alterations in the mechanical, chemical, and electrical properties of the disk tissue. The purpose of this study is to record spatially resolved streaming potential measurements across intervertebral disks exposed to cyclic compressive loading. We hypothesize that the streaming potential profile across the disk will vary with radial position and frequency and is proportional to applied load amplitude, according to the presumed fluid-solid relative velocity and measured glycosaminoglycan content. Needle electrodes were fabricated using a linear array of AgAgCl micro-electrodes and inserted into human motion segments in the midline from anterior to posterior. They were connected to an amplifier to measure electrode potentials relative to the saline bath ground. Motion segments were loaded in axial compression under a preload of 500 N, sinusoidal amplitudes of +/-200 N and +/-400 N, and frequencies of 0.01 Hz, 0.1 Hz, and 1 Hz. Streaming potential data were normalized by applied force amplitude, and also compared with paired experimental measurements of glycosaminoglycans in each disk. Normalized streaming potentials varied significantly with sagittal position and there was a significant location difference at the different frequencies. Normalized streaming potential was largest in the central nucleus region at frequencies of 0.1 Hz and 1.0 Hz with values of approximately 3.5 microVN. Under 0.01 Hz loading, normalized streaming potential was largest in the outer annulus regions with a maximum value of 3.0 microVN. Correlations between streaming potential and glycosaminoglycan content were significant, with R(2) ranging from 0.5 to 0.8. Phasic relationships between applied force and electrical potential did not differ significantly by disk region or frequency, although the largest phase angles were observed at the outermost electrodes. Normalized streaming potentials were associated with glycosaminoglycan content, fluid, and ion transport. Results suggested that at higher frequencies the transport of water and ions in the central nucleus region may be larger, while at lower frequencies there is enhanced transport near the periphery of the annulus. This study provides data that will be helpful to validate multiphasic models of the disk.

Effects of mechanical compression on metabolism and distribution of oxygen and lactate in intervertebral disc

The objective of this study was to examine the effects of mechanical compression on metabolism and distributions of oxygen and lactate in the intervertebral disc (IVD) using a new formulation of the triphasic theory. In this study, the cellular metabolic rates of oxygen and lactate were incorporated into the newly developed formulation of the mechano-electrochemical mixture model [Huang, C.-Y., Gu, W.Y., 2007. Effect of tension-compression nonlinearity on solute transport in charged hydrated fibrosus tissues under dynamic unconfined compression. Journal of Biomechanical Engineering 129, 423-429]. The model was used to numerically analyze metabolism and transport of oxygen and lactate in the IVD under static or dynamic compression. The theoretical analyses demonstrated that compressive loading could affect transport and metabolism of nutrients. Dynamic compression increased oxygen concentration, reduced lactate accumulation, and promoted oxygen consumption and lactate production (i.e., energy conversion) within the IVD. Such effects of dynamic loading were dependent on strain level and loading frequency, and more pronounced in the IVD with less permeable endplate. In contrast, static compression exhibited inverse effects on transport and metabolism of oxygen and lactate. The theoretical predictions in this study are in good agreement with those in the literature. This study established a new theoretical model for analyzing cellular metabolism of nutrients in hydrated, fibrous soft tissues under mechanical compression.

A measurement technique to evaluate the macroscopic permeability of the vertebral end-plate

The remodelling response of vertebral segments in idiopathic scoliosis or disc degeneration, shows a modification of the disc hydration. The investigation of mass transport between the disc and the vertebral body is relevant to understanding the normal and pathological behaviour of the spine. The measurement method we adopted, to derive the macroscopic permeability of the vertebral end-plate, used the relaxation pressure due to a transient-flow rate into the biological structure. Our approach mimicked the in vivo conditions of mass transfer between the disc and the vertebral bodies. It minimized the flow-induced matrix compaction and it allowed the boundary conditions of the specimen to be controlled. We proposed a specific theoretical method and an associated device according to poroelastic theory. A preliminary evaluation with a controlled porous medium, preceded a pilot study in an animal model (lumbar L(4)-L(5) segment of a 4 months old female pig). The macroscopic permeability of multilayered cylindrical specimens including the trabecular bone, subchondral bone and cartilage end-plate was measured, using a 'cartilage-towards-bone' fluid flow direction. A histologic evaluation completed the biomechanical approach. Results showed that the central zone was more permeable than the periphery and this concurred with qualitative studies from the literature.

Arthroscopic evaluation of cartilage degeneration using indentation testing--influence of indenter geometry

BACKGROUND

It has been suggested that the early onset of cartilage degeneration might be detected with a handheld indentation probe during knee arthroscopy, prior to any visible change on the articular surface. Collagen degradation has been considered as the first sign of cartilage degeneration. Therefore, it is important to consider the collagen network as a distinct constituent in the study of arthroscopic evaluation of cartilage degeneration.

METHODS

The tip of an arthroscopic probe (indenter) was modeled as rigid and in contact with a cartilage/bone disk of sufficiently large radius to simulate an indentation in a joint. A fibril-reinforced model of cartilage, including streaming potentials and distinct constitutive laws for the proteoglycan matrix and collagen network, was used to determine the contact mechanics of indenter and cartilage. The finite element package ABAQUS was employed to obtain numerical solutions.

FINDINGS

A spherical indenter produces a relatively uniform deformation in cartilage, but can easily slide on the articular surface. In contrast, a cylindrical indenter produces great deformation gradients for quick compression rates, but does not slide as easily on the articular surface as the spherical indenter. Small porous and large solid indenters should be used to evaluate the properties of the proteoglycan matrix and collagen network, respectively, in order to minimize or maximize the fluid pressure in the corresponding case. When the collagen network is substantially degraded, the gradients of fluid pressure and deformation are greatly reduced regardless of indenter geometry.

INTERPRETATION

The indenter geometry including its porosity is important to the material safety of articular cartilage in indentation and precise evaluation of cartilage degeneration.

Confined compression experiments on bovine nucleus pulposus and annulus fibrosus: sensitivity of the experiment in the determination of compressive modulus and hydraulic permeability

The biphasic material properties for nucleus pulposus tissue in confined compression have not been reported previously, and are required for a better understanding of intervertebral disc function and to provide material properties for use in finite-element models. The aims of this study were to determine linear and non-linear material properties for nucleus pulposus and annulus fibrosus tissues in confined compression, to define the influence of swelling conditions on these properties, and to determine the changes in the compressive modulus and hydraulic permeability induced by the repetition of the stress-relaxation experiment after a return to swelling pressure equilibrium. Specimens from caudal bovine nucleus and annulus were tested in confined compression stress-relaxation experiments and analyzed to quantify the compressive modulus and hydraulic permeability using linear and non-linear biphasic models. Our results suggested the use of confined swelling pre-test condition and non-linear biphasic model, which provided the material parameters with lowest relative variance and water content most representative of physiological conditions. Smaller compressive modulus and higher hydraulic permeability were obtained for the nucleus (H(A0)=0.31+/-0.04 MPa, k(0)=0.67+/-0.09 x 10(-15)m(4)/Ns) than for the annulus (H(A0)=0.74+/-0.13 MPa, k(0)=0.23+/-0.19 x 10(-15)m(4)/Ns), with relatively weak non-linearities. Strains up to 20% resulted in material properties that were significantly altered upon retesting. These altered material properties are an effort to quantify non-recoverable damage that occurs in disc tissue and suggest that in vivo exposure of disc tissues to low strain-rate and high-deformation loading conditions which outpace biological repair may result in altered mechanical behaviors.

Electromechanical response of articular cartilage in indentation--considerations on the determination of cartilage properties during arthroscopy

A finite element formulation of streaming potentials in articular cartilage was incorporated into a fibril-reinforced model using the commercial software ABAQUS. This model was subsequently used to simulate interactions between an arthroscopic probe and articular cartilage in a knee joint. Fibril reinforcement was found to account for large fluid pressure at considerable strain rates, as has been observed in un-confined compression. Furthermore, specific electromechanical responses were associated with specific changes in tissue properties that occur with cartilage degeneration. For example, the strong strain-rate dependence of the load response was only observed when the collagen network was intact. Therefore, it is possible to use data measured during arthroscopy to evaluate the degree of cartilage degeneration and the source causing changed properties. However, practical problems, such as the difficulty of controlling the speed of the hand-held probe, may greatly reduce the reliability of such evaluations. The fibril-reinforced electromechanical model revealed that high-speed transient responses were associated with the collagen network, and equilibrium response was primarily determined by proteoglycan matrix. The results presented here may be useful in the application of arthroscopic tools for evaluating cartilage degeneration, for the proper interpretation of data, and for the optimization of data collection during arthroscopy.

Cell mechanics and mechanobiology in the intervertebral disc

STUDY DESIGN

A review is presented on current knowledge of the micromechanical factors in the intervertebral disc, their role in modifying cell biology, and changes with degeneration.

OBJECTIVES

To identify current knowledge, knowledge gaps, and areas for future research in micromechanics of the intervertebral disc.

SUMMARY OF BACKGROUND DATA

Mechanical factors play important roles in the initiation and progression of intervertebral disc degeneration. Evidence suggests that substantial biologic remodeling occurs in the intervertebral disc in response to mechanical stimuli that may play a critical role in determining the fate of a degenerating intervertebral disc. Information is needed on the precise mechanical stimuli that these cells experience and the mechanisms that govern their responses.

METHODS

A review is presented of cell morphology, cell mechanics, and the internal strains and other mechanical factors predicted to occur at the cell level. A review of intervertebral disc cell responses to well-controlled physical stimuli is also presented with a focus on in vitro studies of explants and isolated cells.

RESULTS

Important differences in cell morphology, mechanics, micromechanical factors, and mechanobiology are noted to occur between cells of the nucleus pulposus and anulus fibrosus. Changes in these features with degeneration are critically understudied, particularly degeneration-associated changes in cell morphology, cell mechanics, and altered physiology with mechanical loading.

CONCLUSIONS

Information on the mechanisms that govern cell responses to mechanical stimuli in the intervertebral disc are just emerging. Studies must address determination of the factors that control micromechanical stimuli, but also mechanisms by which mechanics may interact with genetic factors to regulate expression and remodeling of extracellular matrix molecules, cytokines and mediators of pain and inflammation in degenerating tissue.

Mechanical conditions that accelerate intervertebral disc degeneration: overload versus immobilization

STUDY DESIGN

A review of the literature on macromechanical factors that accelerate disc degeneration with particular focus on distinguishing the roles of immobilization and overloading.

OBJECTIVE

This review examines evidence from the literature in the areas of biomechanics, epidemiology, animal models, and intervertebral disc physiology. The purpose is to examine: 1) what are the degeneration-related alterations in structural, material, and failure properties in the disc; and 2) evidence in the literature for causal relationships between mechanical loading and alterations in those structural and material properties that constitute disc degeneration.

SUMMARY OF BACKGROUND DATA

It is widely assumed that the mechanical environment of the intervertebral disc at least in part determines its rate of degeneration. However, there are two plausible and contrasting theories as to the mechanical conditions that promote degeneration: 1) mechanical overload; and 2) reduced motion and loading.

RESULTS

There are a greater number of studies addressing the "wear and tear" theory than the immobilization theory. Evidence is accumulating to support the notion that there is a "safe window" of tissue mechanical conditions in which the discs remain healthy.

CONCLUSIONS

It is concluded that probably any abnormal loading conditions (including overload and immobilization) can produce tissue trauma and/or adaptive changes that may result in disc degeneration. Adverse mechanical conditions can be due to external forces, or may result from impaired neuromuscular control of the paraspinal and abdominal muscles. Future studies will need to evaluate additional unquantified interactions between biomechanics and factors such as genetics and behavioral responses to pain and disability.

Influence of fixed charge density magnitude and distribution on the intervertebral disc: applications of a poroelastic and chemical electric (PEACE) model

A 3-dimensional formulation for a poroelastic and chemical electric (PEACE) model is presented and applied to an intervertebral disc slice in a 1-dimensional validation problem and a 2-dimensional plane stress problem. The model was used to investigate the influence of fixed charge density magnitude and distribution on this slice of disc material. Results indicated that the mechanical, chemical, and electrical behaviors were all strongly influenced by the amount as well as the distribution of fixed charges in the matrix. Without any other changes in material properties, alterations in the fixed charge density (proteoglycan content) from a healthy to a degenerated distribution will cause an increase in solid matrix stresses and can affect whether the tissue imbibes or exudes fluid under different loading conditions. Disc tissue with a degenerated fixed charge density distribution exhibited greater solid matrix stresses and decreased streaming potential, all of which have implications for disc nutrition, disc biomechanics, and tissue remodeling. It was also seen that application of an electrical potential across the disc can induce fluid transport.

Apparatus for measuring the swelling dependent electrical conductivity of charged hydrated soft tissues

This paper describes a new apparatus and method for measuring swelling dependent electrical conductivity of charged hydrated soft tissues. The apparatus was calibrated using a conductivity standard. Swelling dependent specific conductivity of porcine annulus fibrosis (AF) samples was determined. The conductivity values for porcine AF were similar to those for human and bovine articular cartilage found in the literature. Results revealed a significant linear correlation between specific conductivity and water content for porcine AF tissues tested in phosphate buffered saline (PBS).

Electrical conductivity of lumbar anulus fibrosis: effects of porosity and fixed charge density

STUDY DESIGN

Experimental investigation of the electrical conductivity of normal and trypsin-treated lumbar anulus fibrosis specimens.

OBJECTIVES

To measure the electrical conductivity of intervertebral disc tissues and to study the effects of tissue porosity (volume fraction of water) and fixed charge density on the electrical conductivity of anulus fibrosis in physiologic saline.

SUMMARY OF BACKGROUND DATA

Specific electrical conductivity is one of the material properties of intervertebral discs. Their value depends on ion concentrations and ion diffusivities within the tissue, which in turn are functions of tissue composition and structure. To our knowledge, the electrical conductivity of intervertebral discs has not been studied. Investigation of the electrical conductivity of intervertebral discs and understanding of their relationship to tissue porosity and fixed charge density will provide insights into electromechanical phenomena (e.g., streaming potential) and ion transport in intervertebral discs.

METHODS

A total of 35 porcine lumbar anulus fibrosis specimens were divided into two groups: one control group (n = 10) and one trypsin-treated group (n = 25). The specimens in the control group were subjected to one-dimensional free swelling in phosphate-buffered saline (pH 7.4), and electrical conductivity and porosity (water content) were measured over a period of about 45 minutes. The specimens in the treated group were immersed in a trypsin solution (372 U/mL phosphate-buffered saline) for 45 minutes at room temperature, and the electrical conductivity and porosity were measured after treatment. The electrical conductivity was correlated to tissue porosity for the control and treated specimens. The influences of porosity and fixed charge density were studied.

RESULTS

The average value for control specimens was 5.60 +/- 0.89 mS/cm (mean +/- SD; n = 10) before swelling and 9.11 +/- 0.90 mS/cm (mean +/- SD; n = 10) after swelling. Tissue porosity increased from 0.74 +/- 0.03 (mean +/- SD; n = 10) before swelling to 0.83 +/- 0.02 (mean +/- SD; n = 10) after swelling. The trypsin treatment reduced anulus fibrosis porosity by 3.6% (P < 0.05) and conductivity by 13% (P < 0.05) compared to those for control specimens after swelling. No significant changes werefound in wet and dry tissue densities between control and treated groups. There was a significant, linear correlation between conductivity and porosity for control anulus fibrosis specimens (R2 = 0.87; 86 measurements).

CONCLUSIONS

Measured electrical conductivity was sensitive to tissue porosity, but not to fixed charged density for anulus fibrosis specimens in phosphate-buffered saline.

Mechano-electrochemical properties of articular cartilage: their inhomogeneities and anisotropies

In this chapter, the recent advances in cartilage biomechanics and electromechanics are reviewed and summarized. Our emphasis is on the new experimental techniques in cartilage mechanical testing, new experimental and theoretical findings in cartilage biomechanics and electromechanics, and emerging theories and computational modeling of articular cartilage. The charged nature and depth-dependent inhomogeneity in mechano-electrochemical properties of articular cartilage are examined, and their importance in the normal and/or pathological structure-function relationships with cartilage is discussed, along with their pathophysiological implications. Developments in theoretical and computational models of articular cartilage are summarized, and their application in cartilage biomechanics and biology is reviewed. Future directions in cartilage biomechanics and mechano-biology research are proposed.