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Maniglio D, Bissoli E, Callone E, Dirè S, Motta A. Polymeric Hydrogels for Intervertebral Disc Replacement/Integration: Playing with the Chemical Composition for Tuning Shear Behavior and Hydrophilicity. Gels 2023; 9:912. [PMID: 37999002 PMCID: PMC10671477 DOI: 10.3390/gels9110912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023] Open
Abstract
Damages to the intervertebral disc (IVD) due to improper loading or degeneration result in back pain, which is a common disease affecting an increasing number of patients. Different strategies for IVD remediation have been developed, from surgical treatment to disc replacement, by using both metallic and non-metallic materials. Hydrogels are very attractive materials due to their ability to simulate the properties of many soft tissues; moreover, their chemical composition can be varied in order to assure performances similar to the natural disc. In particular, for the replacement of the IVD outer ring, namely, the anulus fibrosus, the shear properties are of paramount importance. In this work, we produced hydrogels through the photo-induced crosslinking of different mixtures composed of two hydrophilic monofunctional and difunctional polymers, namely, poly(ethyleneglycol) methyl ether methacrylate (PEGMEMA) and poly(ethyleneglycol) dimethacrylate (PEGDMA), together with a hydrophobic molecule, i.e., tert-butyl acrylate (tBA). By changing the ratio among the precursors, we demonstrated the tunability of both the shear properties and hydrophilicity. The structural properties of hydrogels were studied by solid-state nuclear magnetic resonance (NMR). These experiments provided insights on both the structure and molecular dynamics of polymeric networks and, together with information obtained by differential scanning calorimetry (DSC), allowed for correlating the physical properties of the hydrogels with their chemical composition.
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Affiliation(s)
- Devid Maniglio
- BIOtech Research Center, Department of Industrial Engineering, University of Trento, Via Delle Regole 101, 38123 Trento, Italy; (D.M.); (A.M.)
| | - Elia Bissoli
- BIOtech Research Center, Department of Industrial Engineering, University of Trento, Via Delle Regole 101, 38123 Trento, Italy; (D.M.); (A.M.)
- “Klaus Müller” Magnetic Resonance Lab., Department of Industrial Engineering, University of Trento, Via Sommarive 9, 38123 Trento, Italy
| | - Emanuela Callone
- “Klaus Müller” Magnetic Resonance Lab., Department of Industrial Engineering, University of Trento, Via Sommarive 9, 38123 Trento, Italy
| | - Sandra Dirè
- “Klaus Müller” Magnetic Resonance Lab., Department of Industrial Engineering, University of Trento, Via Sommarive 9, 38123 Trento, Italy
| | - Antonella Motta
- BIOtech Research Center, Department of Industrial Engineering, University of Trento, Via Delle Regole 101, 38123 Trento, Italy; (D.M.); (A.M.)
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Daniel Glad Stephen JAM, Prakash M. The influence of the viscoelastic property of polycarbonate urethane as an artificial disc core material under various physiological motions at the L4-L5 level. Int J Artif Organs 2022; 45:957-965. [PMID: 35922957 DOI: 10.1177/03913988221116137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Intervertebral disc (IVD) degeneration is one of the musculoskeletal disorders due to the Degenerative Disc Disease (DDD), that cause low back pain (LBP) and leads to a reduced range of motion. Spinal fusion and arthroplasty are the other surgical procedures that could replace the disc affected by DDD against artificial disc replacement (ADR). This study aims to analyse the biomechanical behaviour of proposed core material as Polycarbonate Urethane (PCU) in the L4-L5 lumbar segment for ADR with Ti-6Al-4V and Co-28Cr-6M as endplate materials and compare it to the performance of an ultra-high molecular weight polyethylene (UHMWPE) core. Finite element methods have been approached to measure the overall stress distribution along with other physiological motions like Flexion (FLEX), Extension (EXT), Axial rotation (AR) and Lateral bending (LB), respectively. Preload of 450 N compressive load, 8 N-m for Flex, 6 N-m for EXT, 6 N-m for AR and 4 N-m for LB are applied. It could be concluded that Ti-6Al-4V - PCU and Co-28Cr-6M - PCU is the best composition for the ADR for the L4-L5 level.
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Affiliation(s)
| | - Muniyandi Prakash
- Department of Mechanical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai, India
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Foizer GA, Paiva VCD, Nascimento RDD, Gorios C, Cliquet Júnior A, Miranda JBD. Is There Any Association between the Severity of Disc Degeneration and Low Back Pain? Rev Bras Ortop 2022; 57:334-340. [PMID: 35652022 PMCID: PMC9142238 DOI: 10.1055/s-0041-1735831] [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: 11/06/2020] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To access the possibility that higher degrees of disc degeneration lead to higher levels of pain and dysfunction. Methods Magnetic resonance imaging (MRI) scans of 85 patients with low back pain lasting for more than 12 weeks were evaluated, and the degree of disc degeneration was quantified according to the Pfirrmann grading system. The Pfirrmann degree in each disc space from L1-L2 to L5-S1, the maximum degree of Pfirrmann (Pfirrmann-max) between the lumbar discs, and the sum of Pfirrmann (Pfirrmann-sum) degrees were correlated (through the Spearman test) with the Oswestry Disability Index (ODI) and the Visual Analogical Scale (VAS) for pain. Results In total, 87% of the patients had moderate to severe lumbar disc degeneration measured by Pfirrmann-max, and the most degenerated discs were L4-L5 and L5-S1. There was a week to moderate correlation regarding the Pfirrmann-max (r = 0,330; p = 0.002) and the Pfirrmann-sum (r = 0,266; p = 0,037) and the ODI, and the Pfirrmann scores in L1-L2 were correlated with the ODI and the VAS. Conclusion Patients with chronic idiopathic low back pain frequently have moderate to severe lumbar disc degeneration, which has a negative impact on the quality of life of the patients. Low degrees of degeneration in L1-L2 might be related with higher degrees of pain and of functional disability.
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Affiliation(s)
- Guilherme Augusto Foizer
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
- Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil
| | | | | | - Carlos Gorios
- Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil
| | - Alberto Cliquet Júnior
- Departamento de Ortopedia, Reumatologia e Traumatologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | - João Batista de Miranda
- Departamento de Ortopedia, Reumatologia e Traumatologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
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Ekram S, Khalid S, Salim A, Khan I. Regulating the fate of stem cells for regenerating the intervertebral disc degeneration. World J Stem Cells 2021; 13:1881-1904. [PMID: 35069988 PMCID: PMC8727226 DOI: 10.4252/wjsc.v13.i12.1881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/12/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
Lower back pain is a leading cause of disability and is one of the reasons for the substantial socioeconomic burden. The etiology of intervertebral disc (IVD) degeneration is complicated, and its mechanism is still not completely understood. Factors such as aging, systemic inflammation, biochemical mediators, toxic environmental factors, physical injuries, and genetic factors are involved in the progression of its pathophysiology. Currently, no therapy for restoring degenerated IVD is available except pain management, reduced physical activities, and surgical intervention. Therefore, it is imperative to establish regenerative medicine-based approaches to heal and repair the injured disc, repopulate the cell types to retain water content, synthesize extracellular matrix, and strengthen the disc to restore normal spine flexion. Cellular therapy has gained attention for IVD management as an alternative therapeutic option. In this review, we present an overview of the anatomical and molecular structure and the surrounding pathophysiology of the IVD. Modern therapeutic approaches, including proteins and growth factors, cellular and gene therapy, and cell fate regulators are reviewed. Similarly, small molecules that modulate the fate of stem cells for their differentiation into chondrocytes and notochordal cell types are highlighted.
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Affiliation(s)
- Sobia Ekram
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan
| | - Shumaila Khalid
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan
| | - Asmat Salim
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan
| | - Irfan Khan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan.
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Stem Cell Therapy and Exercise for Treatment of Intervertebral Disc Degeneration. Stem Cells Int 2021; 2021:7982333. [PMID: 34691192 PMCID: PMC8528633 DOI: 10.1155/2021/7982333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/13/2021] [Indexed: 02/07/2023] Open
Abstract
As part of the motor system, intervertebral disc (IVD) is a complicated tissue with multiple components. The degeneration of IVD may result in low back pain (LBP), which strongly impairs quality of life. Various causes are related to the degeneration of IVD, including cell senescence, hydration lost, and inflammation. Stem cells founded in different tissues have attracted the interest of the researchers and clinicians to study the implication of these cells in the treatment for tissue injury and degeneration. In this report, we will review the study of stem cells in the treatment for IVD degeneration. On the other hand, the effect of exercise on IVD degeneration and the relationship between IVD degeneration and musculoskeletal disorders like sarcopenia are discussed.
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Walters JD, Gill SS, Mercuri JJ. Ethanol-mediated compaction and cross-linking enhance mechanical properties and degradation resistance while maintaining cytocompatibility of a nucleus pulposus scaffold. J Biomed Mater Res B Appl Biomater 2019; 107:2488-2499. [PMID: 30767383 PMCID: PMC6697250 DOI: 10.1002/jbm.b.34339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 12/11/2018] [Accepted: 01/26/2019] [Indexed: 01/01/2023]
Abstract
Intervertebral disc degeneration is a complex, cell-mediated process originating in the nucleus pulposus (NP) and is associated with extracellular matrix catabolism leading to disc height loss and impaired spine kinematics. Previously, we developed an acellular bovine NP (ABNP) for NP replacement that emulated human NP matrix composition and supported cell seeding; however, its mechanical properties were lower than those reported for human NP. To address this, we investigated ethanol-mediated compaction and cross-linking to enhance the ABNP's dynamic mechanical properties and degradation resistance while maintaining its cytocompatibility. First, volumetric and mechanical effects of compaction only were confirmed by evaluating scaffolds after various immersion times in buffered 28% ethanol. It was found that compaction reached equilibrium at ~30% compaction after 45 min, and dynamic mechanical properties significantly increased 2-6× after 120 min of submersion. This was incorporated into a cross-linking treatment, through which scaffolds were subjected to 120 min precompaction in buffered 28% ethanol prior to carbodiimide cross-linking. Their dynamic mechanical properties were evaluated before and after accelerated degradation by ADAMTS-5 or MMP-13. Cytocompatibility was determined by seeding stem cells onto scaffolds and evaluating viability through metabolic activity and fluorescent staining. Compacted and cross-linked scaffolds showed significant increases in DMA properties without detrimentally altering their cytocompatibility, and these mechanical gains were maintained following enzymatic exposure. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2488-2499, 2019.
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Affiliation(s)
- Joshua D. Walters
- The Laboratory of Orthopaedic Tissue Regeneration & Orthobiologics, Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Sanjitpal S. Gill
- Department of Orthopaedic Surgery, Medical Group of the Carolinas-Pelham, Spartanburg Regional Healthcare System, Greer, SC, USA
| | - Jeremy J. Mercuri
- The Laboratory of Orthopaedic Tissue Regeneration & Orthobiologics, Department of Bioengineering, Clemson University, Clemson, SC, USA
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Chetoui MA, Boiron O, Ghiss M, Dogui A, Deplano V. Assessment of intervertebral disc degeneration-related properties using finite element models based on
$$\uprho _H$$
ρ
H
-weighted MRI data. Biomech Model Mechanobiol 2018; 18:17-28. [DOI: 10.1007/s10237-018-1064-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/24/2018] [Indexed: 12/22/2022]
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