Focal defects in the annulus fibrosus (AF) of the intervertebral disc (IVD) arising from herniation have detrimental impacts on the IVD's mechanical function. Thus, biomimetic-based repair strategies must restore the mechanical integrity of the AF to help support and restore native spinal loading and motion. Accordingly, an annulus fibrosus repair patch (AFRP); a collagen-based multi-laminate scaffold with an angle-ply architecture has been previously developed, which demonstrates similar mechanical properties to native outer AF (oAF). To further enhance the mimetic nature of the AFRP, interlamellar (ILM) glycosaminoglycan (GAG) was incorporated into the scaffolds. The ability of the scaffolds to withstand simulated impact loading and resist herniation of native IVD tissue while contributing to the restoration of spinal kinematics were assessed separately. The results demonstrate that incorporation of a GAG-based ILM significantly increased (p<0.001) the impact strength of the AFRP (2.57 ± 0.04 MPa) compared to scaffolds without (1.51 ± 0.13 MPa). Additionally, repair of injured functional spinal units (FSUs) with an AFRP in combination with sequestering native NP tissue and a full-thickness AF tissue plug enabled the restoration of creep displacement (p=0.134), short-term viscous damping coefficient (p=0.538), the long-term viscous (p=0.058) and elastic (p=0.751) damping coefficients, axial neutral zone (p=0.908), and axial range of motion (p=0.476) to an intact state. Lastly, the AFRP scaffolds were able to prevent native IVD tissue herniation upon application of supraphysiologic loads (5.28 ± 1.24 MPa). Together, these results suggest that the AFRP has the strength to sequester native NP and AF tissue and/or implants, and thus, can be used in a composite repair strategy for IVDs with focal annular defects thereby assisting in the restoration of spinal kinematics.

The angle‐ply multilaminate structure of the annulus fibrosus is not reestablished following discectomy which leads to reherniation of the intervertebral disc (IVD). Biomimetic scaffolds developed to repair these defects should be evaluated for their ability to support tissue regeneration by endogenous and exogenous cells. Herein a collagen‐based, angle‐ply multilaminate patch designed to repair the outer annulus fibrosus was assessed for its ability to support mesenchymal stromal and annulus fibrosus cell viability, elongation, alignment, extracellular matrix gene expression, and scaffold remodeling. Results demonstrated that the cells remained viable, elongated, and aligned along the collagen fiber preferred direction of the scaffold, upregulated genes associated with annulus fibrosus matrix and produced collagen on the scaffold yielding biaxial mechanical properties that resembled native annulus fibrosus tissue. In conclusion, these scaffolds have demonstrated their potential to promote a living repair of defects in the annulus fibrosus and thus may be used to prevent recurrent IVD herniations.

Focal defects in the annulus fibrosus (AF) of the intervertebral disc (IVD) from herniation or surgical injury have detrimental impacts on IVD mechanical function. Thus, biomaterial-based repair strategies, which can restore the mechanical integrity of the AF and support long-term tissue regeneration are needed. Accordingly, a collagen-based multi-laminate scaffold with an underlying "angle-ply" architecture has been previously reported demonstrating similar mechanical properties to native AF tissue. The objectives of this work were to: 1) enhance the biomaterials impact strength, 2) define its contribution to spinal kinematics, and 3) assess its ability to prevent IVD herniation. First, AFRP's were enriched with a glycosaminoglycan-based (GAG) interlamellar matrix (ILM), and then tested for its radially-directed impact resistance under physiological stresses. Subsequent kinematic testing was conducted using a characterized GAGenriched AFRP as an AF focal defect closure device. In summary, AFRPs demonstrated 1) incorporation of a GAG-based ILM significantly increased radial impact strength, 2) restoration of axial FSU kinematics and 3) ability to prevent herniation of native IVD tissues. Together, these results suggest that the AFRP demonstrates the mechanical robustness and material properties to restore an IVD's physiological mechanical function through the adequate closure of an AF focal defect.