Vertebral Column Allografts for the Treatment of Segmental Spine Defects

Ej, Olson; En, Hanley; Mj, Rudert; Me, Baratz

doi:10.1097/00007632-199109000-00013

Cited by 35 publications

(12 citation statements)

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“…However, NP cell composition is different between the human and the pig. Notochordal cells are present in the NP throughout the life of the pig but not in the human after the teenage years (Pazzaglia et al, 1989). With this limitation, we believe the findings in this study may provide a guideline useful for future IVD cryopreservation studies.…”

Section: Scw Chan Et Al Cryopreservation Of Whole Intervertebral Discsmentioning

confidence: 89%

Minimizing cryopreservation-induced loss of disc cell activity for storage of whole intervertebral discs

Chan

Lam²,

Leung³

et al. 2010

eCM

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Severe intervertebral disc (IVD) degeneration often requires disc excision and spinal fusion, which leads to loss of spinal segment mobility. Implantation of an allograft disc or tissue engineered disc construct emerges as an alternative to artificial disc replacement for preserving the motion of the degenerated level. Establishment of a bank of cadaveric or engineered cryopreserved discs enables size matching, and facilitates clinical management. However, there is a lack of understanding of the behaviour of disc cells during cryopreservation, as well as how to maximize their survival, such that disc graft properties can be preserved. Here, we report on the effect of alterations in cooling rates, cryoprotective agents (CPAs), and duration of precryopreservation incubation in CPA on cellular activity in whole porcine lumbar discs. Our results indicated that cooling rates of -0.3°C/min and -0.5°C /min resulted in the least loss of metabolic activity in nucleus pulposus (NP) and annulus fibrosus (AF) respectively, while metabolic activity is best maintained by using a combination of 10% dimethylsulphoxide (DMSO) and 10% propylene-glycol (PG) as CPA. By the use of such parameters, metabolic activity of the NP and the AF cells could be maintained at 70% and 45%, respectively, of that of the fresh tissue. Mechanical testing and histological evaluation showed no significant differences in mechanical properties or alterations in disc structure compared to fresh discs. Despite the limitations of the animal model, our findings provide a framework for establishing an applicable cryopreservation protocol for human disc allografts or tissue-engineered disc constructs.

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Section: Scw Chan Et Al Cryopreservation Of Whole Intervertebral Discsmentioning

confidence: 89%

Minimizing cryopreservation-induced loss of disc cell activity for storage of whole intervertebral discs

Chan

Lam²,

Leung³

et al. 2010

eCM

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“…IVD and vertebral body graft transplants have been used successfully in animal models [26,61,81] and more recently in humans [95] and serve as proof-of-concept for biological disc replacement. As autografts are not an option and use of allografts is limited by availability and their ability to transmit disease, research groups have been developing methods to generate a functional spinal unit using tissue-engineering principles.…”

Section: Tissue Engineering and The Intervertebral Discmentioning

confidence: 99%

Tissue engineering and the intervertebral disc: the challenges

2008

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Disc degeneration is a common disorder. Although the back pain that can develop in association with this is rarely life-threatening, the annual cost in terms of morbidity, lost productivity, medical expenses and workers' compensation benefits is significant. Surgical intervention as practised currently is directed towards removing the damaged or altered tissue. Development of new treatment modalities is critical as there is a growing consensus that the strategies used currently for symptomatic degenerative disc disease may not be effective. Accordingly, there is a need to develop an entirely new way to treat this disorder; regenerative medicine and tissue engineering approaches appear particularly promising in this regard. This paper reviews some of the challenges that currently are limiting the clinical application of this approach to the treatment of disc degeneration.

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“…IVD and vertebral body allograft and autograft transplants have restored spinal stability and biomechanics in dog models. [23][24][25] As this approach may be limited by availability of tissue, others have examined whether repairing the NP alone is sufficient to delay IVD degeneration. 26 -29 Reinsertion of autologous NP cells was found to delay degeneration of the entire vertebral body in experimental models of disc degeneration.…”

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confidence: 99%