Biologic Annulus Fibrosus Repair: A Review of Preclinical In Vivo Investigations

Tissue Engineering. Part B, Reviews
Stephen R SloanLawrence J Bonassar

Abstract

Lower back pain, the leading cause of workplace absences and disability, is often attributed to intervertebral disc degeneration, in which nucleus pulposus (NP) herniates through lesions in the annulus fibrosus (AF) and impinges on the spinal cord and surrounding nerves. Surgeons remove extruded NP via discectomy when indicated by local/radicular pain supported by radiographic evidence; however, current interventions do not alter the underlying disease or seal the AF. The reported rates of recurrent herniation or pain following discectomy cases range from 5% to 25%, which has pushed spine research in recent years toward annular repair and closure strategies. Synthetic implants designed to mechanically seal the AF have been subject to large animal and clinical trials, with limited success in preventing recurrent herniation. Like gold standard interventions, purely mechanical devices fail to promote tissue integration, long-term healing, or restore native biomechanical function to the spine. Biological repair strategies utilizing principles of tissue engineering have demonstrated success in overcoming the inadequacies of current interventions and mechanical implants, yet, none has reached clinical or proof-of-concept trials in hu...Continue Reading

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Citations

Jan 4, 2019·Annals of the New York Academy of Sciences·Olivia M TorreJames C Iatridis
Jul 16, 2020·International Journal of Molecular Sciences·Javad TavakoliJoanne L Tipper
Sep 11, 2020·Tissue Engineering. Part B, Reviews·Ana P PeredoRobert L Mauck
May 19, 2021·Veterinary Radiology & Ultrasound : the Official Journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association·Jeryl JonesJeremy Mercuri

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