期刊
JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME
卷 138, 期 2, 页码 -出版社
ASME
DOI: 10.1115/1.4032353
关键词
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资金
- National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health [R01AR057397]
- Collaborative Research Partner Program on Annulus Fibrosus Rupture of the AO Foundation, Davos, Switzerland
- Traineeship, the National Institute of General Medical Science of the NIH Integrated Pharmacological Sciences Training Program [T32 GM062754]
There is currently a lack of clinically available solutions to restore functionality to the intervertebral disk (IVD) following herniation injury to the annulus fibrosus (AF). Microdiscectomy is a commonly performed surgical procedure to alleviate pain caused by herniation; however, AF defects remain and can lead to accelerated degeneration and painful conditions. Currently available AF closure techniques do not restore mechanical functionality or promote tissue regeneration, and have risk of reherniation. This review determined quantitative design requirements for AF repair materials and summarized currently available hydrogels capable of meeting these design requirements by using a series of systematic PubMed database searches to yield 1500+ papers that were screened and analyzed for relevance to human lumbar in vivo measurements, motion segment behaviors, and tissue level properties. We propose a testing paradigm involving screening tests as well as more involved in situ and in vivo validation tests to efficiently identify promising biomaterials for AF repair. We suggest that successful materials must have high adhesion strength (similar to 0.2 MPa), match as many AF material properties as possible (e.g., approximately 1 MPa, 0.3 MPa, and 30 MPa for compressive, shear, and tensile moduli, respectively), and have high tensile failure strain (similar to 65%) to advance to in situ and in vivo validation tests. While many biomaterials exist for AF repair, few undergo extensive mechanical characterization. A few hydrogels show promise for AF repair since they can match at least one material property of the AF while also adhering to AF tissue and are capable of easy implantation during surgical procedures to warrant additional optimization and validation.
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