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Mechanical restoration and failure analyses of a hydrogel and scaffold composite strategy for annulus fibrosus repair

Paper ID Volume ID Publish Year Pages File Format Full-Text
178 12 2016 10 PDF Available
Title
Mechanical restoration and failure analyses of a hydrogel and scaffold composite strategy for annulus fibrosus repair
Abstract

Unrepaired defects in the annulus fibrosus of intervertebral disks are associated with degeneration and persistent back pain. A clinical need exists for a disk repair strategy that can seal annular defects, be easily delivered during surgical procedures, and restore biomechanics with low risk of herniation. Multiple annulus repair strategies were developed using poly(trimethylene carbonate) scaffolds optimized for cell delivery, polyurethane membranes designed to prevent herniation, and fibrin-genipin adhesive tuned to annulus fibrosus shear properties. This three-part study evaluated repair strategies for biomechanical restoration, herniation risk and failure mode in torsion, bending and compression at physiological and hyper-physiological loads using a bovine injury model. Fibrin-genipin hydrogel restored some torsional stiffness, bending ROM and disk height loss, with negligible herniation risk and failure was observed histologically at the fibrin-genipin mid-substance following rigorous loading. Scaffold-based repairs partially restored biomechanics, but had high herniation risk even when stabilized with sutured membranes and failure was observed histologically at the interface between scaffold and fibrin-genipin adhesive. Fibrin-genipin was the simplest annulus fibrosus repair solution evaluated that involved an easily deliverable adhesive that filled irregularly-shaped annular defects and partially restored disk biomechanics with low herniation risk, suggesting further evaluation for disk repair may be warranted.Statement of significanceLower back pain is the leading cause of global disability and commonly caused by defects and failure of intervertebral disk tissues resulting in herniation and compression of adjacent nerves. Annulus fibrosus repair materials and techniques have not been successful due to the challenging mechanical and chemical microenvironment and the needs to restore biomechanical behaviors and promote healing with negligible herniation risk while being delivered during surgical procedures. This work addressed this challenging biomaterial and clinical problem using novel materials including an adhesive hydrogel, a scaffold capable of cell delivery, and a membrane to prevent herniation. Composite repair strategies were evaluated and optimized in quantitative three-part study that rigorously evaluated disk repair and provided a framework for evaluating alternate repair techniques.

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Keywords
AF, annulus fibrosus; IVD, intervertebral disk; NP, nucleus pulposus; FibGen, genipin-crosslinked fibrin gel; PTMC, poly(trimethylene carbonate); PMMA, polymethylmethacrylate; PBS, phosphate buffered saline; DMSO, dimethyl sulfoxide; ROM, range of motionA
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Mechanical restoration and failure analyses of a hydrogel and scaffold composite strategy for annulus fibrosus repair
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Publisher
Database: Elsevier - ScienceDirect
Journal: Acta Biomaterialia - Volume 30, 15 January 2016, Pages 116–125
Authors
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Subjects
Physical Sciences and Engineering Chemical Engineering Bioengineering
Get Full-Text Now
Don't Miss Today's Special Offer
Price was $35.95
You save - $31
Price after discount Only $4.95
100% Money Back Guarantee
Full-text PDF Download
Online Support
Any Questions? feel free to contact us