Department of Biomedical Engineering, Rensselaer Polytechnic Institute, 1108 th Street, JEC 7044, Troy, NY, 12180, USA.
Albany Stratton VA Medical Center, Albany, NY, USA.
Eur Spine J. 2022 May;31(5):1088-1098. doi: 10.1007/s00586-022-07239-2. Epub 2022 May 6.
The intervertebral disc degenerates with age and has a poor propensity for regeneration. Small molecule transport plays a key role in long-term degradation and repair. Convection (bulk flow), induced by low rate cyclic loading of the intervertebral disc, has been shown to increase transport of small molecules. However, the potential therapeutic benefit of low rate cyclic loading on degenerated discs has not been described. The purpose of this study was to determine if a sustained (daily) low rate cyclic loading regimen could slow, arrest, or reverse intervertebral disc degeneration in the rabbit lumbar spine.
Fifty-six New Zealand white rabbits (>12 months old) were designated as either Control (no disc puncture), 8D (disc puncture followed by 8 weeks of degeneration), 16D (disc puncture followed by 16 weeks of degeneration), or Therapy (disc puncture followed by 8 weeks of degeneration and then 8 weeks of daily low rate cyclic loading). Specimens were evaluated by T2 mapping, Pfirrmann scale grading, nucleus volume, disc height index, disc morphology and structure, and proteoglycan content.
In every metric, mean values for the Therapy group fell between Controls and 8D animals. These results suggest that sustained low rate cyclic loading had a therapeutic effect on the already degenerated disc and the regimen promoted signs of regeneration. If these results translate clinically, this approach could fulfil a significant clinical need by providing a means of non-invasively treating intervertebral disc degeneration.
椎间盘随年龄退化，再生能力差。小分子转运在长期降解和修复中起着关键作用。椎间盘的低速率循环加载诱导的对流（体流）已被证明可增加小分子的转运。然而，低速率循环加载对退变椎间盘的潜在治疗益处尚未描述。本研究的目的是确定持续（每日）低速率循环加载方案是否可以减缓、阻止或逆转兔腰椎间盘的退行性变。
56 只新西兰白兔（>12 个月大）被指定为对照组（无椎间盘穿刺）、8D 组（椎间盘穿刺后 8 周退变）、16D 组（椎间盘穿刺后 16 周退变）或治疗组（椎间盘穿刺后 8 周退变，然后 8 周每日低速率循环加载）。通过 T2 映射、Pfirrmann 分级、核体积、椎间盘高度指数、椎间盘形态和结构以及蛋白聚糖含量评估标本。
在每个指标中，治疗组的平均值均介于对照组和 8D 动物之间。这些结果表明，持续的低速率循环加载对已经退变的椎间盘有治疗作用，并促进了再生的迹象。如果这些结果在临床上得到转化，这种方法可以通过提供一种非侵入性治疗椎间盘退变的方法来满足显著的临床需求。
