Nikkhoo Mohammad, Wang Jaw-Lin, Abdollahi Masoud, Hsu Yu-Chun, Parnianpour Mohamad, Khalaf Kinda
1 Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.
2 Institute of Biomedical Engineering, College of Medicine and Engineering, National Taiwan University, Taipei, Taiwan, ROC.
Proc Inst Mech Eng H. 2017 Feb;231(2):127-137. doi: 10.1177/0954411916681597. Epub 2016 Dec 25.
Degenerative disc disease, associated with discrete structural changes in the peripheral annulus and vertebral endplate, is one of the most common pathological triggers of acute and chronic low back pain, significantly depreciating an individual's quality of life and instigating huge socioeconomic costs. Novel emerging therapeutic techniques are hence of great interest to both research and clinical communities alike. Exogenous crosslinking, such as Genipin, and platelet-rich plasma therapies have been recently demonstrated encouraging results for the repair and regeneration of degenerated discs, but there remains a knowledge gap regarding the quantitative degree of effectiveness and particular influence on the mechanical properties of the disc. This study aimed to investigate and quantify the material properties of intact (N = 8), trypsin-denatured (N = 8), Genipin-treated (N = 8), and platelet-rich plasma-treated (N = 8) discs in 32 porcine thoracic motion segments. A poroelastic finite element model was used to describe the mechanical properties during different treatments, while a meta-model analytical approach was used in combination with ex vivo experiments to extract the poroelastic material properties. The results revealed that both Genipin and platelet-rich plasma are able to recover the mechanical properties of denatured discs, thereby affording promising therapeutic modalities. However, platelet-rich plasma-treated discs fared slightly, but not significantly, better than Genipin in terms of recovering the glycosaminoglycans content, an essential building block for healthy discs. In addition to investigating these particular degenerative disc disease therapies, this study provides a systematic methodology for quantifying the detailed poroelastic mechanical properties of intervertebral disc.
椎间盘退变与外周纤维环和椎体终板的离散结构变化相关，是急慢性下腰痛最常见的病理触发因素之一，严重降低个人生活质量并引发巨大的社会经济成本。因此，新兴的治疗技术引起了研究界和临床界的极大兴趣。外源性交联，如京尼平，以及富血小板血浆疗法最近已被证明在退变椎间盘的修复和再生方面取得了令人鼓舞的结果，但在有效性的定量程度以及对椎间盘力学性能的具体影响方面仍存在知识空白。本研究旨在调查和量化32个猪胸椎运动节段中完整椎间盘（N = 8）、胰蛋白酶变性椎间盘（N = 8）、京尼平处理椎间盘（N = 8）和富血小板血浆处理椎间盘（N = 8）的材料特性。使用多孔弹性有限元模型来描述不同处理过程中的力学性能，同时使用元模型分析方法结合体外实验来提取多孔弹性材料特性。结果表明，京尼平和富血小板血浆都能够恢复变性椎间盘的力学性能，从而提供了有前景的治疗方式。然而，在恢复糖胺聚糖含量方面，富血小板血浆处理的椎间盘比京尼平略好，但差异不显著，而糖胺聚糖是健康椎间盘的重要组成部分。除了研究这些特定的椎间盘退变治疗方法外，本研究还提供了一种系统的方法来量化椎间盘详细的多孔弹性力学性能。
