Biomechanical analysis of annulus fibrosus restore with scaffold and comfortable anchors in an ex vivo porcine mannequin.
SICOT J. 2018;four:38
Authors: Rickers Ok, Bendtsen M, Le DQS, Veen AJ, Bünger CE
INTRODUCTION: Altered biomechanical properties, on account of intervertebral disc (IVD) degeneration and lacking nucleus fibrosus, might be thought as one of many causes for the again ache many herniation sufferers expertise after surgical procedure. It has been instructed to restore annulus fibrosus (AF) to revive stability and permit nucleus pulposus (NP) alternative and moreover stop reherniation. The intention of this examine was to judge a brand new technique for closing a defect in AF to be used in herniation surgical procedure.
METHODS: Our restore technique combines a polycaprolactone (PCL) scaffold plugging herniation and comfortable anchors to safe the plug. Ex vivo biomechanical testing was carried out in 9 porcine lumbar movement segments. Flexion-extension, lateral bending and rotation had been repeated 3 times: first in wholesome specimens, second with a full thickness round defect utilized, and third time with the specimens repaired. Lastly push out assessments had been carried out to verify whether or not the plug would stay in.
RESULTS: Checks confirmed that making use of a defect to the AF will increase the vary of movement (ROM), impartial zone (NZ) and impartial zone stiffness (NZS). In flexion/extension it was discovered vital for ROM, NZ, and NZS. For lateral bending and rotation a major enhance in ROM occurred. After AF restore ROM, NZ and NZS had been normalized. All plugs remained within the AF throughout push out check up till 4000?N, however NP was squeezed out by means of the pores of the scaffold.
DISCUSSION: A defect within the AF adjustments the biomechanical properties within the movement section, adjustments that time to instability. Repairing the defect with a PCL plug and comfortable anchors introduced the biomechanical habits again to native state. This idea is promising and may be a viable option to restore the IVD after surgical procedure.
PMID: 30192225 [PubMed]