Abstract
Approximately 50–70% of patients who underwent sequestrectomy after experiencing a disc herniation still report of back pain [23, 25]. Persistent, severe lower back pains demand for additional surgical therapies in about 10% of these cases. Most of the described ailments are due to the fact that the surgically corrected disc, although reduced in size, is still exposed to full weight bearing. Decreases in disc height and intradiscal pressure as well as increases in radial disc bulge in relation to the mass of excised tissue were described by Brinckmann and Grootenboer using an in vitro model [3]. Increases in shear stress after partial denucleation in combination with the lack of a regenerative intrinsic healing process to substitute the removed disc tissue can lead to a progressive degeneration of the affected intervertebral disc [20, 21]. Later on, the instability of the disc results in degenerative changes in the adjacent levels, which may make surgical re-interventions and in the worst case a spinal-fusion surgery necessary. Therefore, disc restoration rather than sole discectomy seems to be the future for intervertebral disc treatments. As the metabolic activity of the disc chondrocytes was defined essential for the health of the disc [2, 7, 13, 18], options for the biological treatment and restoration of degenerated discs became the focus of novel treatment options.
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Libera, J. et al. (2009). Intervertebral Disc Regeneration. In: Meyer, U., Handschel, J., Wiesmann, H., Meyer, T. (eds) Fundamentals of Tissue Engineering and Regenerative Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77755-7_23
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DOI: https://doi.org/10.1007/978-3-540-77755-7_23
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