Vergroesen Pieter-Paul A, Bochyn Ska Agnieszka I, Emanuel Kaj S, Sharifi Shahriar, Kingma Idsart, Grijpma Dirk W, Smit Theodoor H
*Department of Orthopedic Surgery, VU University Medical Center, Amsterdam, the Netherlands †MOVE Research Institute Amsterdam, Amsterdam, the Netherlands ‡Department of Biomaterials Science and Technology, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands §Department of Orthopedics, Orthopedic Research Laboratory, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands ¶Department of Biomedical Engineering, University of Groningen, University Medical Centre Groningen, W.J. Kolff Institute, Groningen, the Netherlands; and ‖Department of Human Movement Sciences, VU University, Amsterdam, the Netherlands.
Spine (Phila Pa 1976). 2015 May 1;40(9):622-8. doi: 10.1097/BRS.0000000000000792.
A biodegradable glue was biomechanically tested for annulus closure using nondegenerated goat intervertebral discs. Ultimate strength and endurance tests were performed using native and punctured discs as positive and negative controls, respectively.
The aim of this study was to investigate the feasibility and biomechanical properties of a biodegradable glue for annulus closure.
There is an unmet clinical need for annulus closure techniques. Isocyanate-terminated tissue glues show potential because they adhere to annulus tissue, have an elastic modulus similar to the annulus, and show limited cytotoxicity to human annulus fibrosus cells.
Three biomechanical tests were performed divided in 2 parts: part 1: ultimate strength tests comparing native, punctured (2.4-mm needle), and glued caprine intervertebral discs (n = 11 per group); part 2: 10 discs per group were subjected to a 10-day ex vivo endurance test of 864,000 load cycles, followed by ultimate strength tests. Outcome parameters include the restoration of strength after puncture, reduction of herniation in the endurance test, and conservation of glue strength after endurance testing.
Part 1: The glue partially restored subsidence to failure and yield strength/ultimate strength ratio of intervertebral discs. Part 2: During endurance testing, 40% of punctured discs failed compared with none of the glued discs. Endurance testing did not affect glue strength, and pooling of ultimate strength tests showed that the glue restored ultimate strength, work to failure, and yield strength/ultimate strength to 79%, 75%, and 119% of native values, respectively.
A biodegradable isocyanate-terminated glue increases the force at which nucleus protrusion occurs, and it limits herniations during endurance or ultimate strength tests. Biomechanical tests in a bioreactor provide a low-cost assessment for annulus repair strategies; however, the clinical efficacy needs to be further addressed using long-term in vivo studies.
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使用未退变的山羊椎间盘对一种可生物降解胶水进行生物力学测试，以评估其用于闭合纤维环的效果。分别以完整椎间盘和穿刺后的椎间盘作为阳性和阴性对照，进行极限强度和耐久性测试。
本研究旨在探讨一种可生物降解胶水用于闭合纤维环的可行性及生物力学特性。
临床上对纤维环闭合技术存在未满足的需求。异氰酸酯封端的组织胶水具有潜力，因为它们能粘附于纤维环组织，弹性模量与纤维环相似，且对人纤维环细胞的细胞毒性有限。
进行了三项生物力学测试，分为两部分：第1部分：极限强度测试，比较完整、穿刺（2.4毫米针头）和使用胶水处理的山羊椎间盘（每组n = 11）；第2部分：每组10个椎间盘进行为期10天的体外耐久性测试，加载864,000个循环，随后进行极限强度测试。结果参数包括穿刺后强度的恢复、耐久性测试中突出物的减少以及耐久性测试后胶水强度的保持。
第1部分：胶水部分恢复了椎间盘的沉降至失效以及屈服强度/极限强度比。第2部分：在耐久性测试中，40%的穿刺椎间盘失效，而使用胶水处理的椎间盘无一失效。耐久性测试未影响胶水强度，极限强度测试结果汇总显示，胶水分别将极限强度、失效功和屈服强度/极限强度恢复至完整椎间盘相应值的79%、75%和119%。
一种可生物降解的异氰酸酯封端胶水增加了髓核突出时的力，并在耐久性或极限强度测试中限制了突出。生物反应器中的生物力学测试为纤维环修复策略提供了低成本评估；然而，临床疗效需要通过长期体内研究进一步验证。
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