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A biological approach to treating disc degeneration: not for today, but maybe for tomorrow

  • Conference paper
Arthroplasty of the Spine

Abstract

The intervertebral disc unites the vertebrae in the spine, providing the flexibility required for bending and twisting and resisting the compression inflicted by gravity when in an upright posture. The discs have a complex structure, with the outer annulus fibrosus having lamellae of organized collagen fibrils and the inner nucleus pulposus having a more random collagen organization and an abundance of aggregating proteoglycans. This composite nature endows the disc with both the tension-resisting properties of a ligament and the compression-resisting properties of articular cartilage. Unfortunately, disc structure and function does not remain optimal throughout life, but undergoes progressive degeneration, commencing in the young adult, and is particularly evident in the nucleus pulposus. With time, disc degeneration may result in clinical symptoms, such as low back pain, and require medical intervention. Such treatment may involve removal of the offending disc by surgery rather than its repair, which would be the preferred course of action. In the near future, current bio-engineering techniques may offer the possibility of repairing the damaged disc, if an engineered tissue with the appropriate functional properties can be generated to augment the ailing disc. In this report, we summarized our recent results, in which disc cells were implanted into a scaffold of collagen and hyaluronan, or entrapped into a chitosan gel, and growth factors were used to modulate matrix synthesis in an attempt to produce a tissue with a similar molecular composition to native nucleus pulposus tissue.

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Author information

Authors and Affiliations

  1. Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, McGill University, MUHC-RVH site, 687 Pine Avenue, Room L4.70, Montreal, H3A 1A1, Montreal, Canada

    M. Alini, J. Antoniou & M. Aebi

  2. Genetics Unit, Shriners Hospital for Children, McGill University, Montreal, Canada

    P. J. Roughley

  3. Mathys Medical, Bettlach, Switzerland

    T. Stoll

  4. AO Research Institute, Davos, Switzerland

    M. Alini

Authors
  1. M. Alini
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  2. P. J. Roughley
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  3. J. Antoniou
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  4. T. Stoll
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  5. M. Aebi
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Corresponding author

Correspondence to M. Alini .

Editor information

Editors and Affiliations

  1. Eeuwfeestkliniek, Harmoniestraat 68, 2018, Antwerp, Belgium

    Robert Gunzburg

  2. Orthopädische Klinik, München-Harlaching Wirbelsäulenzentrum, Harlachinger Str. 51, 81243, München, Germany

    Heinz Michael Mayer

  3. Centre Hospitalier Molière Longchamps, Rue Marconi 142, 1180, Brussels, Belgium

    Marek Szpalski

  4. Maurice E. Müller Institute for Evaluative Research and Documentation in Orthopaedic Surgery, Murtenstr. 35, 3008, Bern, Switzerland

    Max Aebi

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© 2004 Springer-Verlag Berlin Heidelberg

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Alini, M., Roughley, P.J., Antoniou, J., Stoll, T., Aebi, M. (2004). A biological approach to treating disc degeneration: not for today, but maybe for tomorrow. In: Gunzburg, R., Mayer, H.M., Szpalski, M., Aebi, M. (eds) Arthroplasty of the Spine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18508-3_24

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  • DOI: https://doi.org/10.1007/978-3-642-18508-3_24

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-20295-0

  • Online ISBN: 978-3-642-18508-3

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