Mojica-Santiago Jorge A, Lang Gernot M, Navarro-Ramirez Rodrigo, Hussain Ibrahim, Hӓrtl Roger, Bonassar Lawrence J
Meinig School of Biomedical Engineering Cornell University Ithaca New York.
Weill Cornell Brain and Spine Center, Department of Neurological Surgery Weill Cornell Medicine, New York-Presbyterian Hospital New York New York.
JOR Spine. 2018 Aug 30;1(3):e1031. doi: 10.1002/jsp2.1031. eCollection 2018 Sep.
Total disc replacement using tissue-engineered intervertebral discs (TE-IVDs) may offer a biological alternative to treat radiculopathy caused by disc degeneration. A composite TE-IVD was previously developed and evaluated in rat tail and beagle cervical spine models in vivo. Although cell viability and tissue integration into host tissue were promising, significant implant displacement occurred at multiple spinal levels. The goal of the present study was to assess the effects of a resorbable plating system on the stiffness of motion segments and stability of tissue-engineered implants subjected to axial compression. Canine motion segments from levels C2/C3 to C5/C6 were assessed as intact (CTRL), after discectomy (Dx), with an implanted TE-IVD only (PLATE-), and with a TE-IVD combined with an attached resorbable plate (PLATE+). Segments under PLATE+ conditions fully restored separation between endplates and showed significantly higher compressive stiffness than segments under PLATE- conditions. Plated segments partially restored more than 25% of the CTRL motion segment stiffness. Plate attachment also prevented implant extrusion from the disc space at 50% compressive strain, and this effect was more significant in segments from levels C3/C4 when compared to segments from level C5/C6. These results suggest that stabilization of motion segments via resorbable plating assists TE-IVD retention in the disc space while allowing the opportunity for implants to fully integrate into the host tissue and achieve optimal restoration of spine biomechanics.
使用组织工程化椎间盘（TE-IVD）进行全椎间盘置换可能为治疗椎间盘退变引起的神经根病提供一种生物学替代方法。先前已在大鼠尾部和比格犬颈椎模型体内开发并评估了一种复合TE-IVD。尽管细胞活力和组织与宿主组织的整合前景良好，但在多个脊柱节段发生了明显的植入物移位。本研究的目的是评估可吸收钢板系统对运动节段刚度以及轴向压缩下组织工程化植入物稳定性的影响。对犬的C2/C3至C5/C6节段的运动节段进行评估，分为完整状态（CTRL）、椎间盘切除术后（Dx）、仅植入TE-IVD（PLATE-）以及植入TE-IVD并附加可吸收钢板（PLATE+）。PLATE+条件下的节段完全恢复了终板之间的间隙，并且显示出比PLATE-条件下的节段显著更高的压缩刚度。植入钢板的节段部分恢复了超过25%的CTRL运动节段刚度。钢板固定还在50%压缩应变时防止了植入物从椎间盘间隙挤出，与C5/C6节段相比，这种效果在C3/C4节段更为显著。这些结果表明，通过可吸收钢板稳定运动节段有助于将TE-IVD保留在椎间盘间隙中，同时使植入物有机会完全整合到宿主组织中并实现脊柱生物力学的最佳恢复。
