Challenges and strategies in the repair of ruptured annulus fibrosus

Guterl, Clare C.; See, Eugene Y.; Blanquer, Sebastien B. G.; Pandit, Abhay; Ferguson, Stephen J.; Benneker, Lorin M.; Grijpma, Dirk W.; Sakai, Daisuke; Eglin, David; Alini, Mauro; Iatridis, James C.; Grad, Sibylle (2013). Challenges and strategies in the repair of ruptured annulus fibrosus. European cells & materials eCM, 25, pp. 1-21. University of Wales

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Lumbar discectomy is the surgical procedure most frequently performed for patients suffering from low back pain and sciatica. Disc herniation as a consequence of degenerative or traumatic processes is commonly encountered as the underlying cause for the painful condition. While discectomy provides favourable outcome in a majority of cases, there are conditions where unmet requirements exist in terms of treatment, such as large disc protrusions with minimal disc degeneration; in these cases, the high rate of recurrent disc herniation after discectomy is a prevalent problem. An effective biological annular repair could improve the surgical outcome in patients with contained disc herniations but otherwise minor degenerative changes. An attractive approach is a tissue-engineered implant that will enable/stimulate the repair of the ruptured annulus. The strategy is to develop three-dimensional scaffolds and activate them by seeding cells or by incorporating molecular signals that enable new matrix synthesis at the defect site, while the biomaterial provides immediate closure of the defect and maintains the mechanical properties of the disc. This review is structured into (1) introduction, (2) clinical problems, current treatment options and needs, (3) biomechanical demands, (4) cellular and extracellular components, (5) biomaterials for delivery, scaffolding and support, (6) pre-clinical models for evaluation of newly developed cell- and material-based therapies, and (7) conclusions. This article highlights that an interdisciplinary approach is necessary for successful development of new clinical methods for annulus fibrosus repair. This will benefit from a close collaboration between research groups with expertise in all areas addressed in this review.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
UniBE Contributor:	Benneker, Lorin Michael
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1473-2262
Publisher:	University of Wales
Language:	English
Submitter:	Stephanie Schmutz
Date Deposited:	08 Apr 2014 10:24
Last Modified:	05 Dec 2022 14:29
PubMed ID:	23283636
URI:	https://boris.unibe.ch/id/eprint/42791