David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
J Control Release. 2024 Dec;376:1225-1250. doi: 10.1016/j.jconrel.2024.10.055. Epub 2024 Nov 12.
The development of novel therapeutics in the field of spinal neurosurgery faces a litany of translational challenges. Achieving precise drug targeting within the confined spaces associated with the spinal cord, canal and vertebra requires the development of next generation delivery systems and devices. These must be capable of overcoming inherent barriers related to drug diffusion, whilst concurrently ensuring optimal drug distribution and retention. In this review, we provide an overview of the most recent advances in the therapeutic management of diseases and disorders affecting the spine, including systems and devices capable of releasing small molecules and biopharmaceuticals that help eliminate pain and restore the mechanical function and stability of the spine. We highlight material-based approaches and minimally invasive techniques that can be employed to provide control over drug release kinetics and improve retention. We also seek to explore how the newest advancements in nanotechnology, biomaterials, additive manufacturing technologies and imaging modalities can be employed in this translational pursuit. Finally, we discuss the landscape of clinical trials and recently approved products aimed at overcoming the complexities associated with drug delivery to the spine.
在脊柱神经外科学领域开发新型治疗方法面临着一系列转化挑战。要实现在脊髓、椎管和椎体相关的有限空间内进行精确的药物靶向，需要开发下一代输送系统和装置。这些系统和装置必须能够克服与药物扩散相关的固有障碍，同时确保最佳的药物分布和保留。在这篇综述中，我们概述了治疗影响脊柱的疾病和障碍的最新进展，包括能够释放小分子和生物制药的系统和装置，这些药物有助于消除疼痛并恢复脊柱的机械功能和稳定性。我们强调了可以用来控制药物释放动力学和提高保留率的基于材料的方法和微创技术。我们还试图探讨如何在这一转化研究中利用纳米技术、生物材料、增材制造技术和成像方式的最新进展。最后，我们讨论了旨在克服向脊柱输送药物的复杂性的临床试验和最近批准产品的现状。
