Biological Approaches To Spinal Disc Repair And Regeneration For Clinicians

The human spinal disc : relevant anatomy and physiology / Julien Tremblay-Gravel, Fahad H. Abduljabbar, Jean Ouellet, and Lisbet Haglund -- Pathophysiology of disc disease : disc degeneration / Niloofar Farhang, Joshua Stover, Brandon Lawrence, and Robby D. Bowles -- Imaging of the healthy and diseased spinal disc / Darryl B. Sneag and Hollis G. Potter -- Biomechanics of the healthy and diseased spine / Hans-Joachim Wilke and Fabio Galbusera -- Differences between human and animal discs : pros and cons of current animal models for pre-clinical development of biologic therapies for low back pain / Jeffrey C. Lotz -- Grading scales for disc degeneration and regeneration : clinical and experimental / Peter Grunert -- Disc regeneration : in vitro approaches and experimental results / John T. Martin, Harvey E. Smith, Lachlan J. Smith, and Robert L. Mauck -- Intervertebral disc whole organ cultures / Marianna Peroglio, Zhen Li, Lorin Michael Benneker, Mauro Alini, and Sibylle Grad -- Biological treatment approaches : basic ideas and principles / Victor Y. Leung and Kenneth M. Cheung -- Learning from successes of tissue engineered strategies in non-spine cartilaginous disorders / Stephen Sloan and Lawrence J. Bonassar -- Treatment and of degenerative disc disease and disc regeneration : proteins and genes / Daisuke Sakai and Jordy Schol -- Treatment of degenerated disc disease/disc regeneration : growth factors and platelet-rich plasma / Koichi Masuda and Kenji Kato -- Treatment of degenerated disc disease/disc regeneration : stem cells, chondrocytes or other cells, and tissue engineering / Steven Presciutti and Howard An -- Nucleus replacement and repair : autologous disc chondrocyte transplantation / Christian Hohaus, Timothy Ganey, and Hans Jörg Meisel -- Annulus fibrosus repair / Olivia M. Torre, Michelle A. Cruz, Andrew C. Hecht, and James C. Iatridis -- Summary of clinical trials with biological treatment approaches for spinal disease / Gernot Lang, Ibrahim Hussain, Micaella Zubkov, Yu Moriguchi, Brenton Pennicooke, and Roger Härtl -- Total disc transplantation : current results and future development / Jason Pui Yin Cheung, Dike Ruan, and Keith D.K. Luk -- What have we learned from mechanical total disc replacement? / Timothy T. Roberts, Colin M. Haines, and Edward C. Benzel -- Regulatory overview : obtaining regulatory approval of a biologic/cell product / Michaela H. Purcell, Penny J. White, H. Davis Adkisson -- What makes biological treatment strategies and tissue engineering for ddd interesting to industry? / Hassan Serhan, Elliott A. Gruskin, and William C. Horton -- What will the future bring? : perspectives from around the world / Tony Goldschlager, Claudius Thome, Howard An, and Luiz Vialle

Top Experts Share Clinical Insights on Biological Interventions for Spine-Related Disease Although there have been significant advancements in minimally invasive spinal surgery techniques in the last few decades, optimal outcomes for chronic low back pain remain elusive. A number of promising clinical trials have been conducted using tissue engineering and biological interventions for disc degeneration. Written by renowned innovators, this is the first book that covers implementation of these groundbreaking approaches for disc disease. The text begins with key fundamentals including anatomy and physiology, pathophysiology, imaging and biomechanics to delineate healthy versus diseased spine. Subsequent sections discuss treatment strategies, research findings, and future developments. Throughout each chapter, renowned spine surgeons and scientists share clinical pearls gleaned from hands-on experience. Key Highlights The current state of the art in biological and tissue engineering procedures for spinal disorders Treatment methodologies including nucleus replacement and repair, annulus fibrosus repair, total disc transplantation, and mechanical total disc replacement Innovative treatment strategies for disc regeneration, such as genes and proteins Growth factors including platelet-rich plasma (PRP), which has shown promise for the stimulation and acceleration of bone and soft tissue healing Cell-based therapy for spinal disc regeneration and repair including the use of stem cells and chondrocytes In-depth discussion of research including animal versus human model, in-vitro, and a summary of biologic clinical trials This is a must-have resource for trainee and practicing orthopaedic surgeons and neurosurgeons who treat patients for spine-related conditions. It is essential reading for all clinicians who have an interest in cutting-edge tissue engineering and biological treatment interventions.

Disorders related to the intervertebral disc (IVD) are common causes of morbidity and of severe life quality deterioration. IVD degeneration, although in many cases asymptomatic, is often the origin of painful neck and back diseases. In Western societies IVD related pain and disability account for enormous health care costs as a result of work absenteeism and thus lost production, disability benefits, medical and insurance expenses. Although only a small percentage of patients with disc disorders finally will undergo surgery, spinal surgery has been one of the fastest growing disciplines in the musculoskeletal field in recent years. Nevertheless, current treatment options are still a matter of controversial discussion. In particular, they hardly can restore normal spine biomechanics and prevent degeneration of adjacent tissues. While degeneration affects all areas of the IVD, the most constant and noticeable changes occur in the gel-like central part, the nucleus pulposus (NP). Recent emphasis has therefore been put in biological ways to regenerate the NP; however, there are a number of obstacles to overcome, considering the exceptional biological and biomechanical environment of this tissue. Different biological approaches such as molecular, gene, and cell based therapies have been investigated and have shown promising results in both in vitro and in vivo studies. Nonetheless, considerable hurdles still exist in their application for IVD regeneration in human patients. The choice of the cells and the choice of the cell carrier suitable for implantation pose major challenges for research and development activities. This lecture recapitulates the basics of IVD structure, function, and degeneration mechanisms. The first part reviews the recent progress in the field of disc and stem cell based regenerative approaches. In the second part, most appropriate biomaterials that have been evaluated as cell or molecule carrier to cope with degenerative disc disease are outlined. The potential and limitations of cell- and biomaterial-based treatment strategies and perspectives for future clinical applications are discussed. Table of Contents: Cell Therapy for Nucleus Pulposus Regeneration / Recent Advances in Biomaterial Based Tissue Engineering for Intervertebral Disc Regeneration

Disorders related to the intervertebral disc (IVD) are common causes of morbidity and of severe life quality deterioration. IVD degeneration, although in many cases asymptomatic, is often the origin of painful neck and back diseases. In Western societies IVD related pain and disability account for enormous health care costs as a result of work absenteeism and thus lost production, disability benefits, medical and insurance expenses. Although only a small percentage of patients with disc disorders finally will undergo surgery, spinal surgery has been one of the fastest growing disciplines in the musculoskeletal field in recent years. Nevertheless, current treatment options are still a matter of controversial discussion. In particular, they hardly can restore normal spine biomechanics and prevent degeneration of adjacent tissues. While degeneration affects all areas of the IVD, the most constant and noticeable changes occur in the gel-like central part, the nucleus pulposus (NP). Recent emphasis has therefore been put in biological ways to regenerate the NP; however, there are a number of obstacles to overcome, considering the exceptional biological and biomechanical environment of this tissue. Different biological approaches such as molecular, gene, and cell based therapies have been investigated and have shown promising results in both in vitro and in vivo studies. Nonetheless, considerable hurdles still exist in their application for IVD regeneration in human patients. The choice of the cells and the choice of the cell carrier suitable for implantation pose major challenges for research and development activities. This lecture recapitulates the basics of IVD structure, function, and degeneration mechanisms. The first part reviews the recent progress in the field of disc and stem cell based regenerative approaches. In the second part, most appropriate biomaterials that have been evaluated as cell or molecule carrier to cope with degenerative disc disease are outlined. The potential and limitations of cell- and biomaterial-based treatment strategies and perspectives for future clinical applications are discussed. Table of Contents: Cell Therapy for Nucleus Pulposus Regeneration / Recent Advances in Biomaterial Based Tissue Engineering for Intervertebral Disc Regeneration

The intervertebral disc is a complex structure that separates opposing vertebrae, permits a wide range of motion, and accommodates high biomechanical forces. Disc degeneration leads to a loss of function and is often associated with excruciating pain. Written by leading scientists and clinicians, the first part of the book provides a review of the basic biology of the disc in health and disease. The second part considers strategies to mitigate the effects of disc degeneration and discusses the possibility of engineering replacement tissues. The final section is devoted to approaches to model normal development and elucidate the pathogenesis of degenerative disc disease using animal, organ and cell culture techniques. The book bridges the gap between the basic and clinical sciences; the target audience includes basic scientists, orthopaedists and neurologists, while at the same time appealing to the needs of graduate students, medical students, interns and fellows.

Low back pain is a common disorder in the clinical treatment of the Department of Orthopedics. Lumbar intervertebral disc degeneration is a main reason for the chronic pain and the process is difficult to reverse. Traditional treatment methods include conservative treatment and surgical treatment. Although the clinical symptoms caused by intervertebral disc degeneration can be alleviated to a certain extent, these treatment methods do not solve the fundamental issues and they also produce corresponding complications. The rise of tissue engineering technology and its applications in different fields have brought new ideas for the treatment of intervertebral disc degeneration. This book discusses the fundamentals as well as more recent developments in stem cell therapy and tissue engineering technology and offers an alternative for treating degeneration of intervertebral discs.

This handbook is the most authoritative and up-to-date reference on spine technology written for practitioners, researchers, and students in bioengineering and clinical medicine. It is the first resource to provide a road map of both the history of the field and its future by documenting the poor clinical outcomes and failed spinal implants that contributed to problematic patient outcomes, as well as the technologies that are currently leading the way towards positive clinical outcomes. The contributors are leading authorities in the fields of engineering and clinical medicine and represent academia, industry, and international government and regulatory agencies. The chapters are split into five sections, with the first addressing clinical issues such as anatomy, pathology, oncology, trauma, diagnosis, and imaging studies. The second section, on biomechanics, delves into fixation devices, the bone implant interface, total disc replacements, injury mechanics, and more. The last three sections, on technology, are divided into materials, commercialized products, and surgery. All appropriate chapters will be continually updated and available on the publisher’s website, in order to keep this important reference as up-to-date as possible in a fast-moving field.

Joint replacement is a logical step in the treatment of severe joint pathologies with irreversible lesions resisting conservative therapy. At the spinal level, arthrodesis became, very early, the gold standard of treatment for severe intervertebral disc pathologies. The next logical step was to envision functional replacement, and this step was taken as early as 1956, when the first intervertebral implant was described. However, it took many more years and a great variety of proposed implant designs before clinical applications could be attempted.