Advanced Strategies for the Regeneration of Lumbar Disc Annulus Fibrosus

Tavakoli, Javad; Diwan, Ashish D.; Tipper, Joanne L.

doi:10.3390/ijms21144889

Cited by 34 publications

(29 citation statements)

References 156 publications

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“…The asterisk ( * ) indicates that the data at this follow-up time point is statistically significant compared with the data at the previous follow-up time points. 7 BioMed Research International of Xclose and EFit Disposable Annular Stapler device [4][5][6][7]. In our clinical department, additional AF sutures had been attempted in hundreds of cases of soft herniation with successful intraoperative closure.…”

Section: Discussionmentioning

confidence: 99%

“…Bailey et al used an FDA-approved X-close device to suture annulus fibrosus (AF) defect after discectomy [4]. In addition, commercial annular closure devices such as Barricaid implant and Inclose Mesh were used to block off the IVD defect by forming a mechanical barrier [5,6]. However, these repair techniques focus on closing the wound of the defect without functional restoration of the IVD, and some scholars found that the additional annulus fibrosus suture (AFS) had no significant superiority [4,7].…”

Section: Introductionmentioning

confidence: 99%

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Selective Retention of Bone Marrow Stromal Cells with Gelatin Sponge for Repair of Intervertebral Disc Defects after Microendoscopic Discectomy: A Prospective Controlled Study and 2-Year Follow-Up

Zhang

et al. 2021

BioMed Research International

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Objective. Discectomy remains the classic procedure for treating lumbar intervertebral disc (IVD) herniation, but the occurrence of defects after discectomy is thought to be an important cause generating recurrent and accelerated IVD degeneration. Previous studies attempted suture of the annulus fissure, but the validity of this technique on restraining the degenerative process is controversial. On the other hand, cell therapies have been shown in multiple clinical and basic studies. Our purpose was to investigate the effectiveness of selective retention of autologous Bone Marrow Stromal Cells (BMSCs) with gelatin sponge in combination with annulus fibrosus suture (AFS) for the repair of IVD defects following mobile microendoscopic discectomy (MMED). Methods. This prospective, two-armed, and controlled clinical study was conducted from December 2016 to December 2018. Written informed consent was obtained from each patient. Forty-five patients with typical symptoms, positive signs of radiculopathy, and obvious lumbar disc herniation observed by MRI were enrolled. Patients were divided into 3 groups with different treating methods: MMED ( n = 15 ), MMED+AFS ( n = 15 ), and MMED+AFS+BMSCs ( n = 15 ). A postoperative 2-year follow-up was performed to evaluate the patient-reported outcomes of VAS, ODI, and SF-36. The improvement rate of VAS and ODI was calculated as latest ‐ preoperative / preoperative to evaluate the therapeutic effect of the three groups. Assessment parameters included Pfirrmann grade, intervertebral disc height (IDH), and disc protrusion size (DPS), as measured by MRI to evaluate the morphological changes. Results. All patients enrolled had a postoperative follow-up at 3, 6, 12, and 24 months. VAS and ODI scores were significantly improved compared to the preoperative status in all three groups with a mean DPS reduction rate over 50%. At the final follow-up, the improvement rate of the VAS score in the MMED+AFS+BMSCs group was significantly higher than the MMED+AFS and MMED groups ( 80.1 % ± 7.6 % vs. 71.3 % ± 7.0 % vs. 70.1 % ± 7.8 % ), while ODI improvement showed a significant change ( 65.6 % ± 8.8 % vs. 59.9 % ± 5.5 % vs. 57.8 % ± 8.1 % ). All participants showed significant improvement in SF-36 PCS and MCS; the differences between each group were not significant. The mean IDH loss rate of the MMED+AFS+BMSCs group was also significantly lower than other groups ( − 17.2 % ± 1.3 % vs. − 27.6 % ± 0.7 % vs. − 29.3 % ± 2.2 % ). The Pfirrmann grade was aggravated in the MMED and MMED+AFS groups while maintained at the preoperative grade in the MMED+AFS+BMSCs group. No adverse events of cell transplantation or recurrence were found in all patients during the postoperative follow-up period. Conclusions. It is feasible and effective to repair lumbar IVD defects using SCR-enriched BMSCs with gelatin sponges, which warrants further study and development as a cell-based therapy for IVD repair.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Selective Retention of Bone Marrow Stromal Cells with Gelatin Sponge for Repair of Intervertebral Disc Defects after Microendoscopic Discectomy: A Prospective Controlled Study and 2-Year Follow-Up

Zhang

et al. 2021

BioMed Research International

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“…Spinal fusion is regarded as gold standard for treating low back pain caused by IVD degeneration. However, it comes with limited spinal mobility and increased chance of adjacent IVD degeneration [ 119 ].Therefore, many efforts and strategies have been placed on the development of engineered IVD to replace the degenerated IVD [ 120 , 121 , 122 ]. In particular, hydrogels including alginate, chitosan, hyaluronic acid, and collagen have been found to have potential as a scaffold in the IVD degeneration [ 121 , 123 ].…”

Section: Application Of Cac Hydrogelmentioning

confidence: 99%

Collagen–Alginate Composite Hydrogel: Application in Tissue Engineering and Biomedical Sciences

2021

Polymers

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Alginate (ALG), a polysaccharide derived from brown seaweed, has been extensively investigated as a biomaterial not only in tissue engineering but also for numerous biomedical sciences owing to its wide availability, good compatibility, weak cytotoxicity, low cost, and ease of gelation. Nevertheless, alginate lacks cell-binding sites, limiting long-term cell survival and viability in 3D culture. Collagen (Col), a major component protein found in the extracellular matrix (ECM), exhibits excellent biocompatibility and weak immunogenicity. Furthermore, collagen contains cell-binding motifs, which facilitate cell attachment, interaction, and spreading, consequently maintaining cell viability and promoting cell proliferation. Recently, there has been a growing body of investigations into collagen-based hydrogel trying to overcome the poor mechanical properties of collagen. In particular, collagen–alginate composite (CAC) hydrogel has attracted much attention due to its excellent biocompatibility, gelling under mild conditions, low cytotoxicity, controllable mechanic properties, wider availability as well as ease of incorporation of other biomaterials and bioactive agents. This review aims to provide an overview of the properties of alginate and collagen. Moreover, the application of CAC hydrogel in tissue engineering and biomedical sciences is also discussed.

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“…Various complications, such as physiological anatomy change and re-revision surgery, would increase the therapeutic costs and then caused a great economic burden on society. 2 The etiology of IDD was complex and previous studies revealed that increased age, 3 unhealthy behaviors and inflammatory reactions were associated with IDD incidence. 4 Considering the important therapeutic value for the early management of IDD, detecting a potential molecular biomarker would provide both advanced understanding and more potential treatments for the IDD cases.…”

Section: Introductionmentioning

confidence: 99%

Lower Plasma Melatonin in the Intervertebral Disk Degeneration Patients Was Associated with Increased Proinflammatory Cytokines

Tian¹,

Ji²,

Mei³

et al. 2021

CIA

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Background Intervertebral disc degeneration (IDD) was considered to be the pathological basis of intervertebral disc herniation (IDH). However, the plasma melatonin in the IDD cases and healthy controls remained unclear. Methods In this case–control study, a total of 71 IDD cases and 54 healthy controls were enrolled between April 2020 and August 2020. The diagnostic effect of plasma melatonin for IDD was detected using receiver operating characteristic curve. The correlations between two continuous variables were detected with the Pearson linear analyses. Results It was found that lower melatonin concentration was detected in the IDD cases (1.906 ± 1.041 vs 3.072 ± 0.511 pg/mL, P <0.001). Through receiver operating characteristic curve analyses, it was found that plasma melatonin could be used as a diagnostic biomarker for IDD (area under curve=0.808, P <0.001). In advanced correlation analyses, it was found that plasma melatonin concentration was negatively associated with the age, symptom durations, IDD disease severity and proinflammatory factors, including IL-6 and TNF-α concentrations ( P <0.05). Comparing with the higher melatonin groups, significantly increased IL-6 (0.601 ± 0.085 vs 0.507 ± 0.167 pg/mL, P =0.028) and TNF-α (3.022 ± 0.286 vs 2.353 ± 0.641, P <0.001) were detected in the patients with lower melatonin concentration. Conclusion The plasma melatonin concentration was significantly decreased in the IDD cases and plasma melatonin could be used as a diagnostic biomarker for IDD. Lower plasma melatonin was associated with longer disease durations, elevated disease severity and higher inflammatory cytokines levels in IDD patients.

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Advanced Strategies for the Regeneration of Lumbar Disc Annulus Fibrosus

Cited by 34 publications

References 156 publications

Selective Retention of Bone Marrow Stromal Cells with Gelatin Sponge for Repair of Intervertebral Disc Defects after Microendoscopic Discectomy: A Prospective Controlled Study and 2-Year Follow-Up

Selective Retention of Bone Marrow Stromal Cells with Gelatin Sponge for Repair of Intervertebral Disc Defects after Microendoscopic Discectomy: A Prospective Controlled Study and 2-Year Follow-Up

Collagen–Alginate Composite Hydrogel: Application in Tissue Engineering and Biomedical Sciences

Lower Plasma Melatonin in the Intervertebral Disk Degeneration Patients Was Associated with Increased Proinflammatory Cytokines

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