Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral Disc
ABSTRACT Purpose Nucleus augmentation has been proposed as an early‐stage intervention for intervertebral disc degeneration and involves the injection of a biomaterial into the nucleus to restore disc height and functionality. The aim of this work was to identify clinically relevant quantitative mea...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-06-01
|
| Series: | JOR Spine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jsp2.70081 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849425078349987840 |
|---|---|
| author | J. P. Warren A. R. Dixon M. P. Culbert A. Khan M. Mengoni R. K. Wilcox |
| author_facet | J. P. Warren A. R. Dixon M. P. Culbert A. Khan M. Mengoni R. K. Wilcox |
| author_sort | J. P. Warren |
| collection | DOAJ |
| description | ABSTRACT Purpose Nucleus augmentation has been proposed as an early‐stage intervention for intervertebral disc degeneration and involves the injection of a biomaterial into the nucleus to restore disc height and functionality. The aim of this work was to identify clinically relevant quantitative measures that indicate the mechanical performance of the disc following nucleus augmentation. Method Bovine tail bone‐disc‐bone units (n = 22) were mechanically tested under cyclic loading sequentially in native, artificially degenerated, and treated states. Treatment involved injection of a peptide‐glycosaminoglycan mixture into the degenerated disc to a predetermined load using a syringe driver with an integrated force sensor. The stiffness restoration of the treatment was determined by comparing the biomechanical behavior of the native state to the treated state of each disc. The stiffness restoration was then compared against clinically quantifiable parameters. Results No significant biomechanical differences were observed between the native and treated states, but both were significantly different from the degenerated state. The force delivered during injection was found to ramp to a steady state, followed by a final rapid increase; however, all measures associated with injection force poorly correlated with the level of stiffness restoration. Volume injected and change in disc height from injection had the strongest relationship to stiffness restoration. Conclusion This work showed that measuring the injection force for injectable treatments of the disc can provide lower and upper limits for delivery, but direct measures are stronger indicators of disc stiffness restoration. |
| format | Article |
| id | doaj-art-00945a2f76c3475ab039ccffa5700a71 |
| institution | Kabale University |
| issn | 2572-1143 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | JOR Spine |
| spelling | doaj-art-00945a2f76c3475ab039ccffa5700a712025-08-20T03:29:53ZengWileyJOR Spine2572-11432025-06-0182n/an/a10.1002/jsp2.70081Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral DiscJ. P. Warren0A. R. Dixon1M. P. Culbert2A. Khan3M. Mengoni4R. K. Wilcox5University of Leeds, Institute of Medical and Biological Engineering Leeds UKUniversity of Leeds, Institute of Medical and Biological Engineering Leeds UKUniversity of Leeds, Institute of Medical and Biological Engineering Leeds UKLeeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust Leeds UKUniversity of Leeds, Institute of Medical and Biological Engineering Leeds UKUniversity of Leeds, Institute of Medical and Biological Engineering Leeds UKABSTRACT Purpose Nucleus augmentation has been proposed as an early‐stage intervention for intervertebral disc degeneration and involves the injection of a biomaterial into the nucleus to restore disc height and functionality. The aim of this work was to identify clinically relevant quantitative measures that indicate the mechanical performance of the disc following nucleus augmentation. Method Bovine tail bone‐disc‐bone units (n = 22) were mechanically tested under cyclic loading sequentially in native, artificially degenerated, and treated states. Treatment involved injection of a peptide‐glycosaminoglycan mixture into the degenerated disc to a predetermined load using a syringe driver with an integrated force sensor. The stiffness restoration of the treatment was determined by comparing the biomechanical behavior of the native state to the treated state of each disc. The stiffness restoration was then compared against clinically quantifiable parameters. Results No significant biomechanical differences were observed between the native and treated states, but both were significantly different from the degenerated state. The force delivered during injection was found to ramp to a steady state, followed by a final rapid increase; however, all measures associated with injection force poorly correlated with the level of stiffness restoration. Volume injected and change in disc height from injection had the strongest relationship to stiffness restoration. Conclusion This work showed that measuring the injection force for injectable treatments of the disc can provide lower and upper limits for delivery, but direct measures are stronger indicators of disc stiffness restoration.https://doi.org/10.1002/jsp2.70081biomaterialsbiomechanicsintervertebral disc degenerationnucleus augmentationsurgical optimisation |
| spellingShingle | J. P. Warren A. R. Dixon M. P. Culbert A. Khan M. Mengoni R. K. Wilcox Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral Disc JOR Spine biomaterials biomechanics intervertebral disc degeneration nucleus augmentation surgical optimisation |
| title | Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral Disc |
| title_full | Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral Disc |
| title_fullStr | Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral Disc |
| title_full_unstemmed | Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral Disc |
| title_short | Injection Volume Is a Better Predictor of Stiffness Restoration Than Injection Force in an In Vitro Study of Nucleus Augmentation of the Intervertebral Disc |
| title_sort | injection volume is a better predictor of stiffness restoration than injection force in an in vitro study of nucleus augmentation of the intervertebral disc |
| topic | biomaterials biomechanics intervertebral disc degeneration nucleus augmentation surgical optimisation |
| url | https://doi.org/10.1002/jsp2.70081 |
| work_keys_str_mv | AT jpwarren injectionvolumeisabetterpredictorofstiffnessrestorationthaninjectionforceinaninvitrostudyofnucleusaugmentationoftheintervertebraldisc AT ardixon injectionvolumeisabetterpredictorofstiffnessrestorationthaninjectionforceinaninvitrostudyofnucleusaugmentationoftheintervertebraldisc AT mpculbert injectionvolumeisabetterpredictorofstiffnessrestorationthaninjectionforceinaninvitrostudyofnucleusaugmentationoftheintervertebraldisc AT akhan injectionvolumeisabetterpredictorofstiffnessrestorationthaninjectionforceinaninvitrostudyofnucleusaugmentationoftheintervertebraldisc AT mmengoni injectionvolumeisabetterpredictorofstiffnessrestorationthaninjectionforceinaninvitrostudyofnucleusaugmentationoftheintervertebraldisc AT rkwilcox injectionvolumeisabetterpredictorofstiffnessrestorationthaninjectionforceinaninvitrostudyofnucleusaugmentationoftheintervertebraldisc |