Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
Department of Neurological Surgery, Weill Cornell Medical College, New York, NY 10065, USA.
Sci Transl Med. 2020 Mar 11;12(534). doi: 10.1126/scitranslmed.aay2380.
Tissue-engineered approaches for the treatment of early-stage intervertebral disc degeneration have shown promise in preclinical studies. However, none of these therapies has been approved for clinical use, in part because each therapy targets only one aspect of the intervertebral disc's composite structure. At present, there is no reliable method to prevent intervertebral disc degeneration after herniation and subsequent discectomy. Here, we demonstrate the prevention of degeneration and maintenance of mechanical function in the ovine lumbar spine after discectomy by combining strategies for nucleus pulposus augmentation using hyaluronic acid injection and repair of the annulus fibrosus using a photocrosslinked collagen patch. This combined approach healed annulus fibrosus defects, restored nucleus pulposus hydration, and maintained native torsional and compressive stiffness up to 6 weeks after injury. These data demonstrate the necessity of a combined strategy for arresting intervertebral disc degeneration and support further translation of combinatorial interventions to treat herniations in the human spine.
组织工程方法在治疗早期椎间盘退变方面的研究已初见成效。然而，这些疗法都尚未被批准用于临床应用，部分原因是每种疗法仅针对椎间盘复合结构的一个方面。目前，尚无可靠的方法可以预防椎间盘突出和随后的椎间盘切除术之后的椎间盘退变。在这里，我们通过使用透明质酸注射来增强髓核和使用光交联胶原贴修复纤维环的方法相结合，证明了在羊腰椎切除术后可以预防椎间盘退变并维持机械功能。这种联合方法可以治愈纤维环缺损，恢复髓核水分，并保持天然的扭转和压缩刚度，直到损伤后 6 周。这些数据表明，需要联合策略来阻止椎间盘退变，并支持进一步将组合干预措施转化为治疗人类脊柱突出症。
