McKay Orthopaedic Research Laboratory, University of Pennsylvania, 424 Stemmler Hall, 36th Street and Hamilton Walk, Philadelphia, PA 19104, USA.
J Biomech. 2010 Apr 19;43(6):1017-30. doi: 10.1016/j.jbiomech.2009.12.001. Epub 2010 Jan 18.
Due to the inability of current clinical practices to restore function to degenerated intervertebral discs, the arena of disc tissue engineering has received substantial attention in recent years. Despite tremendous growth and progress in this field, translation to clinical implementation has been hindered by a lack of well-defined functional benchmarks. Because successful replacement of the disc is contingent upon replication of some or all of its complex mechanical behaviors, it is critically important that disc mechanics be well characterized in order to establish discrete functional goals for tissue engineering. In this review, the key functional signatures of the intervertebral disc are discussed and used to propose a series of native tissue benchmarks to guide the development of engineered replacement tissues. These benchmarks include measures of mechanical function under tensile, compressive, and shear deformations for the disc and its substructures. In some cases, important functional measures are identified that have yet to be measured in the native tissue. Ultimately, native tissue benchmark values are compared to measurements that have been made on engineered disc tissues, identifying where functional equivalence was achieved, and where there remain opportunities for advancement. Several excellent reviews exist regarding disc composition and structure, as well as recent tissue engineering strategies; therefore this review will remain focused on the functional aspects of disc tissue engineering.
由于目前的临床实践无法恢复退化的椎间盘的功能，近年来椎间盘组织工程领域受到了广泛关注。尽管该领域取得了巨大的发展和进步，但由于缺乏明确的功能基准，其向临床应用的转化受到了阻碍。由于成功替换椎间盘取决于复制其某些或全部复杂的机械行为，因此为了确定组织工程的离散功能目标，对椎间盘力学进行很好的描述是至关重要的。在这篇综述中，讨论了椎间盘的关键功能特征，并将其用于提出一系列天然组织基准，以指导工程化替代组织的开发。这些基准包括对椎间盘及其子结构在拉伸、压缩和剪切变形下的力学功能的测量。在某些情况下，确定了一些重要的功能测量值，这些值尚未在天然组织中进行测量。最终，将天然组织基准值与已在工程化椎间盘组织上进行的测量值进行比较，确定实现功能等效的地方，以及仍有改进空间的地方。关于椎间盘的组成和结构以及最近的组织工程策略已经有一些很好的综述，因此，本综述将继续集中讨论椎间盘组织工程的功能方面。
