The challenge and advancement of annulus fibrosus tissue engineering
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REVIEW ARTICLE
The challenge and advancement of annulus fibrosus tissue engineering Li Jin • Adam L. Shimmer • Xudong Li
Received: 7 June 2012 / Revised: 26 December 2012 / Accepted: 7 January 2013 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Background Intervertebral disc degeneration, a main cause of back pain, is an endemic problem and a big economic burden for the health care system. Current treatments are symptom relieving but do not address underlying problems—biological and structural deterioration of the disc. Tissue engineering is an emerging approach for the treatment of intervertebral disc degeneration since it restores the functionality of native tissues. Although numerous studies have focused on the nucleus pulposus tissue engineering and achieved successes in laboratory settings, disc tissue engineering without annulus fibrosus for the end stage of disc degeneration is deemed to fail. The purpose of this article is to review the advancement of annulus fibrosus tissue engineering. Material and Methods Relevant articles regarding annulus fibrosus tissue engineering were identified in PubMed and Medline databases. Results The ideal strategy for disc regeneration is to restore the function and integrity of the disc by using biomaterials, native matrices, growth factors, and cells that producing matrices. In the past decades there are tremendous advancement in annulus fibrosus tissue engineering including cell biology, biomaterials, and whole disc replacement. The recent promising results on whole disc tissue engineering—a composite of annulus fibrosus and nucleus pulposus—make the tissue engineering approach more appealing.
L. Jin A. L. Shimmer X. Li (&) Department of Orthopaedic Surgery, University of Virginia, Hospital Drive, Cobb Hall B039, P.O. Box 800374, 22908 Charlottesville, VA, USA e-mail: [email protected]
Conclusion Despite the promising results in disc tissue engineering, there is still much work to be done regarding the clinical application. Keywords Tissue engineering Annulus fibrosus Scaffolds Intervertebral disc degeneration
Introduction Intervertebral disc (IVD) degeneration is a common musculoskeletal disease and progresses to disc herniation, spinal canal stenosis, and degenerative spondylolisthesis. The precise etiology of disc degeneration is still far from delineated. Multiple factors have been found involved in the initiation and progression of the disease including aging, loading changes, poor nutrient supply, and hereditary factors [1–7]. IVD degeneration is characterized by changes of cellular microenvironment, loss of proteoglycan, loss of disc height, tears of annulus fibrosus (AF) tissue, spinal stenosis, herniated discs, neoinnervation, hypermobility, and inflammation [8–11]. At present, all treatments for degenerative disc disease are limited to treating the symptoms of the condition. Due to its avascular and aneural structure, the intervertebral disc has little ability to regenerate. When nucleotomy (a surgical treatment for disc herniation) is performe
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