Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
NMR Biomed. 2012 Mar;25(3):443-51. doi: 10.1002/nbm.1651. Epub 2011 Mar 8.
Nonbiological total disc replacement is currently being used for the treatment of intervertebral disc (IVD) disease and injury, but these implants are prone to mechanical wear, tear and possible dislodgement. Recently, tissue-engineered total disc replacement (TE-TDR) has been investigated as a possible alternative to more fully replicate the native IVD properties. However, the performance of TE-TDRs has not been studied in the native disc space. In this study, MRI and microcomputed tomography imaging of the rat spine were used to design a collagen (annulus fibrosus)/alginate (nucleus pulposus) TE-TDR to a high degree of geometric accuracy, with less than 10% difference between TE-TDR and the native disc dimensions. Image-based TE-TDR implants were then inserted into the L4/L5 disc space of athymic rats (n = 5) and maintained for 16 weeks. The disc space was fully or partially maintained in three of five animals and proteoglycan and collagen histology staining was similar in composition to the native disc. In addition, good integration was observed between TE-TDR and the vertebral bodies, as well as remnant native IVD tissue. Overall, this study provides evidence that TE-TDR strategies may yield a clinically viable treatment for diseased or injured IVD.
目前，非生物全椎间盘置换术被用于治疗椎间盘（IVD）疾病和损伤，但这些植入物容易发生机械磨损、撕裂和可能的移位。最近，组织工程全椎间盘置换术（TE-TDR）已被研究作为更完全复制天然 IVD 特性的替代方法。然而，TE-TDR 的性能尚未在天然椎间盘空间中进行研究。在这项研究中，使用 MRI 和大鼠脊柱的微计算机断层扫描成像来设计胶原蛋白（纤维环）/藻酸盐（髓核）TE-TDR，以达到高度的几何精度，TE-TDR 与天然椎间盘尺寸的差异小于 10%。然后，基于图像的 TE-TDR 植入物被插入到去胸腺大鼠的 L4/L5 椎间盘空间（n=5）并维持 16 周。在五名动物中的三名中，椎间盘空间得到了完全或部分维持，并且糖胺聚糖和胶原组织学染色在组成上与天然椎间盘相似。此外，在 TE-TDR 与椎体以及残留的天然 IVD 组织之间观察到了良好的整合。总体而言，这项研究提供了证据表明，TE-TDR 策略可能为患病或受伤的 IVD 提供一种可行的临床治疗方法。
