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Intervertebral Disc Anatomy
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Its highly organised structure produces material behaviour that is anisotropic, principally in tension. It is significantly loaded in tension during physiologic motion due to swelling effects in the nucleus pulposus, as well as applied compressive loads that cause annular bulging and deformation: Encases the nucleus pulposusComposed of type I collagen that is obliquely oriented, water and proteoglycans (PGs)High tensile strength and able to prevent intervertebral distractionHigh collagen/low PG ratioFibroblast-like cells produce type I collagen and PGsNucleus pulposus
Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
The intervertebral discs lie between the vertebral bodies and consist of two regions, with the central, more gelatinous nucleus pulposus surrounded by a fibrous ring, the annulus fibrosus. The discs are separated from the adjacent vertebrae by a thin layer of hyaline cartilaginous tissue, the cartilage endplates.
Regenerative Medicine in Pain Management
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Sharon McQuillan, Rafael Gonzalez
Numerous human studies have shown favorable outcomes utilizing a variety of stem cell sources for discogenic pain. For instance, Mochida et al.45 evaluated the use of autologous cultured nucleus pulposus chondrocytes that were co-cultured with MSCs in nine subjects with Pfirrman grade III disc degeneration and posterior lumbar intervertebral fusion. Patients were examined clinically and evaluated before and 3 years following treatment using the Japanese Orthopedic Association (JOA) scoring system for low back pain and MRI results. Clinical outcomes demonstrated significant improvement in JOA function and pain scores, as well as the safety of activated nucleus pulposus cell transplantation and the efficacy of the procedure to slow disc degeneration. Most importantly, there were no adverse events reported during the 3-year follow-up period.
Development of a finite element lumbar spine model to predict intervertebral disc herniation risk factors
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Stephanie Rossman, Eric Meyer, Steven Rundell
The combined tasks forces of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology define IVD herniation as “localized or focal displacement of disc material beyond the limits of the intervertebral disc space” (Fardon et al. 2014; Schroeder et al. 2016). IVD herniations occur when nucleus pulposus (NP) material migrates through fissures in the annulus fibrosus (AF), and occur most frequently on the posterolateral aspect of the disc (Martin et al. 2002; Wilke et al. 2016). Biomechanically, IVD herniations result from one of two mechanisms: cyclic loading involving compression and bending motions of the spine (Adams and Hutton 1985; Gordon et al. 1991; Callaghan and McGill 2001; Tampier et al. 2007; Wilke et al. 2013; 2016; Berger-Roscher et al. 2017) or a single traumatic event involving high magnitudes of compression with hyper-flexion (Adams and Hutton 1982a; 1982b; Brinckmann 1986; McNally and Adams 1993; Adams and Roughley 2006; Wade et al. 2014).
Parametric study of anterior percutaneous endoscopic cervical discectomy (APECD)
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Meng-Si Sun, Chen-Xi Yuchi, Xin-Yi Cai, Cheng-Fei Du, Zhong-Jun Mo
Following APECD surgery, stability of the surgical segment is among the most important outcomes for patients, as it is also for clinicians. That is because instability of the surgical segment is usually accompanied by various complications, such as a reduction in disc height and acceleration of degeneration of adjacent segments, causing the patient to suffer additional pain and requiring revision surgery which can increase financial pressure on the patient (Carrier et al. 2013). The nucleus pulposus plays a major role in sagittal stability of the cervical spine. From a mechanical point of view, when the cervical vertebral segment moves, the nucleus pulposus immediately participates in supporting the load and ensures that the height of the disc is maintained. The structure allows stress to be evenly distributed around the annulus fibrosus. When the nucleus pulposus becomes degenerated, the fulcrum for this support instantly disappears, reducing the height of the intervertebral disc and providing uneven stress around the ring of fibers, causing it to become easily damaged, and inititating segmental instability.
Numerical simulation of lateral and transforaminal lumbar interbody fusion, two minimally invasive surgical approaches
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
B. Areias, S. C. Caetano, L. C. Sousa, M. Parente, R. N. Jorge, H. Sousa, J. M. Gonçalves
Particular attention is necessary regarding the modelling of the nucleus material, which possesses incompressibility characteristics. The nucleus pulposus, mainly composed of water, is confined in its totality, acting as an incompressible material without fluid flow (del Palomar et al. 2008). Therefore, to characterise its behaviour, a hyperelastic model was considered, in particular, the Neo-Hookean model with 2008) (Moramarco et al. 2010). The annulus fibrosus was modelled as an anisotropic hyperelastic material, according to the HGO constitutive model, with 2012; Momeni Shahraki et al. 2015).