Disc degeneration reduces the delamination strength of the annulus fibrosus in the rabbit annular disc puncture model |
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| Authors: | Diane E Gregory Won C Bae Robert L Sah Koichi Masuda |
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| Institution: | 1. Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, 75 University Ave West, Waterloo, Ontario, Canada, N2L 3C5;2. Department of Orthopaedic Surgery, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA;3. Department of Bioengineering, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA;4. Department of Radiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA;1. Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA;2. Department of Biomedical Engineering, The City College of New York, New York, NY, USA;1. Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, No. 188 Shizi St, Suzhou, Jiangsu 215006, China;2. Department of Orthopedic Surgery, Wuxi Ninth People''s Hospital Affiliated to Soochow University, 999 Liangxi Rd, Wuxi, Jiangsu 214062, China;1. Julius Wolff Institut Charité—Universitätsmedizin Berlin, CVK, Institutsgebäude Süd/Südstraße 2, Augustenburger Platz 1, 13353 Berlin, Germany;2. Institute of Orthopaedic Research and Biomechanics, University of Ulm, Ulm, Germany;1. The Faculty of Engineering, Ariel University, Ariel 4077625, Israel;2. The Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel;3. Institute of Orthopaedic Research and Biomechanics, University of Ulm, Ulm, Germany;4. IRCCS Galeazzi Orthopaedic Institute, Milan, Italy;5. Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;1. School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran;2. Division of Applied Mechanics, Department of Mechanical Engineering, Ecole Polytechnique, Montréal, Québec, Canada |
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| Abstract: | Background contextDegenerative disc disease is a common pathologic disorder accompanied by both structural and biochemical changes. Changes in stress distribution across the disc can lead to annulus fibrosus (AF) damage that can affect the strength and integrity of the disc. Given that some present degeneration therapies incorporate biological regrowth of the nucleus pulposus (NP), it is crucial that the AF remains capable of containing this newly grown material.PurposeTo examine the resistance of AF to delamination using an adhesive peel test in experimentally degenerated rabbit discs.Study designExperimentally induced disc degeneration; excised AF tissue study.MethodsDisc degeneration was induced in eight New Zealand white rabbits by annular puncture; four additional rabbits served as controls. In experimental rabbits, an 18-gauge needle was inserted into the anterolateral AF region of levels L2–L3 and L4–L5, and disc height was monitored by X-ray. Animals were sacrificed at 4 and 12 weeks postsurgery and magnetic resonance images and X-rays were taken. Four discs were excised from the experimental animals; two punctured (L2–L3 and L4–L5) and two controls (L3–L4 and L6–L7). The same four discs were also excised from the age-matched control animals and served as nonpunctured control discs. To determine resistance to delamination, AF samples were dissected from each disc and subjected to a mechanical peel test at 0.5 mm/s.ResultsMagnetic resonance imaging and X-ray images confirmed dehydration of the NP and reduced disc height, similar to that found in clinical degeneration. Resistance to delamination was significantly lower in punctured/degenerated discs compared with both the nonpunctured discs from the same animal (27% lower) and the nonpunctured control discs (30% lower) (p=.024).ConclusionsThe findings of this study suggest that degeneration increases the potential for delamination between AF layers. Given this substantial change to the integrity of the AF after degeneration, clinical treatments should not only target rehydration or regrowth of the NP, but should also target repair and strengthening of the AF to confine the NP. |
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| Keywords: | Annulus fibrosus Lamellae Disc herniation Animal model Puncture Disc therapy |
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