Two-Step Approach Helps Repair Herniated Discs
By HospiMedica International staff writers Posted on 01 Apr 2020 |
Image: This riboflavin infused collagen gel stiffens into a solid when illuminated (Photo courtesy of Cornell University)
A combined therapeutic approach helps heal annulus fibrosus defects, restore nucleus pulposus hydration, and maintain native torsional and compressive stiffness, according to a new study.
Developed by researchers at Cornell University (Cornell; Ithaca, NY, USA), the Hospital for Special Surgery (HSS, New York, NY, USA), and other institutions, the acellular, tissue-engineered technique is designed to prevent degeneration after a discectomy procedure. The two-step technique involves first injecting hyaluronic acid into the inner region of the disc--the nucleus pulposus--and subsequently applying a photo-crosslinked collagen patch to the healed outer annulus fibrosus defects. The collagen patch also incorporates riboflavin, a photoactive vitamin B derivative.
Instead of suturing the ruptured disc, the riboflavin is activated by shining a light on it, which causes the thick gel to stiffen into a solid. Importantly, the gel provides a fertile ground for cells to grow new tissue, sealing the defect better than any suture could. The researchers found the technique successfully healed the damage to the annulus fibrosus, restored disc height, and maintained mechanical performance and biomechanical support of the spine up to six weeks after injury. The study was published on March 11, 2020, in Science Translational Medicine.
“This is really a new avenue and a whole new approach to treating people who have herniated discs, other than walking around with a big hole in their intervertebral disc and hoping that it doesn’t re-herniate or continue to degenerate,” said senior author Lawrence Bonassar, PhD, of Cornell University. “The idea is, if you have a herniation and you’ve lost some material from the nucleus, now we can re-inflate the disc with this hyaluronic acid gel and put the collagen cross-linking seal on the outside. Now we’ve refilled the tire and sealed it.”
The intervertebral discs are composed of two parts: a stiffer external tissue called the annulus fibrosis, and a softer, gelatinous material in the center, the nucleus pulposus, which keeps the disc pressurized and able to hold its shape and height during physical movement. If the outer layer ruptures, the jelly-like nucleus pulposus leaks out, causing inflammation in the nerve root or the spinal cord itself.
Related Links:
Cornell University
Hospital for Special Surgery
Developed by researchers at Cornell University (Cornell; Ithaca, NY, USA), the Hospital for Special Surgery (HSS, New York, NY, USA), and other institutions, the acellular, tissue-engineered technique is designed to prevent degeneration after a discectomy procedure. The two-step technique involves first injecting hyaluronic acid into the inner region of the disc--the nucleus pulposus--and subsequently applying a photo-crosslinked collagen patch to the healed outer annulus fibrosus defects. The collagen patch also incorporates riboflavin, a photoactive vitamin B derivative.
Instead of suturing the ruptured disc, the riboflavin is activated by shining a light on it, which causes the thick gel to stiffen into a solid. Importantly, the gel provides a fertile ground for cells to grow new tissue, sealing the defect better than any suture could. The researchers found the technique successfully healed the damage to the annulus fibrosus, restored disc height, and maintained mechanical performance and biomechanical support of the spine up to six weeks after injury. The study was published on March 11, 2020, in Science Translational Medicine.
“This is really a new avenue and a whole new approach to treating people who have herniated discs, other than walking around with a big hole in their intervertebral disc and hoping that it doesn’t re-herniate or continue to degenerate,” said senior author Lawrence Bonassar, PhD, of Cornell University. “The idea is, if you have a herniation and you’ve lost some material from the nucleus, now we can re-inflate the disc with this hyaluronic acid gel and put the collagen cross-linking seal on the outside. Now we’ve refilled the tire and sealed it.”
The intervertebral discs are composed of two parts: a stiffer external tissue called the annulus fibrosis, and a softer, gelatinous material in the center, the nucleus pulposus, which keeps the disc pressurized and able to hold its shape and height during physical movement. If the outer layer ruptures, the jelly-like nucleus pulposus leaks out, causing inflammation in the nerve root or the spinal cord itself.
Related Links:
Cornell University
Hospital for Special Surgery
Latest Surgical Techniques News
- Miniaturized Implantable Multi-Sensors Device to Monitor Vessels Health
- Tiny Robots Made Out Of Carbon Could Conduct Colonoscopy, Pelvic Exam or Blood Test
- Miniaturized Ultrasonic Scalpel Enables Faster and Safer Robotic-Assisted Surgery
- AI Assisted Reading Tool for Small Bowel Video Capsule Endoscopy Detects More Lesions
- First-Ever Contact Force Pulsed Field Ablation System to Transform Treatment of Ventricular Arrhythmias
- Caterpillar Robot with Built-In Steering System Crawls Easily Through Loops and Bends
- Tiny Wraparound Electronic Implants to Revolutionize Treatment of Spinal Cord Injuries
- Small, Implantable Cardiac Pump to Help Children Awaiting Heart Transplant
- Gastrointestinal Imaging Capsule a Game-Changer in Esophagus Surveillance and Treatment
- World’s Smallest Laser Probe for Brain Procedures Facilitates Ablation of Full Range of Targets
- Artificial Intelligence Broadens Diagnostic Abilities of Conventional Coronary Angiography
- AI-Powered Surgical Visualization Tool Supports Surgeons' Visual Recognition in Real Time
- Cutting-Edge Robotic Bronchial Endoscopic System Provides Prompt Intervention during Emergencies
- Handheld Device for Fluorescence-Guided Surgery a Game Changer for Removal of High-Grade Glioma Brain Tumors
- Porous Gel Sponge Facilitates Rapid Hemostasis and Wound Healing
- Novel Rigid Endoscope System Enables Deep Tissue Imaging During Surgery