Collagen fibre orientation in the annulus fibrosus of intervertebral disc during bending and torsion measured by x-ray diffraction

X-ray diffraction has been used to measure the orientation of the collagen fibres in the ventral annulus fibrosus of intact L1/2 rabbit intervertebral disc during in vitro bending and torsion. Fibres are tilted with respect to the axis of the spine. As predicted by theory, fibre tilt decreases in those regions of the annulus which are stretched by bending but increases in the slackened regions. Good agreement with the quantitative predictions of bending theory was obtained in three of the six series of experiments, the predicted trend being found in all six. Tilt direction alternates in successive lamellae of the annulus. When discs were subjected to both clockwise and anticlockwise torsion of 5°, the two families of titled fibres reoriented in the expected directions.     

Type III collagen in the intervertebral disc.

Several collagen types have now been isolated from the intervertebral disc, although type III collagen has previously only been extracted from human pathological disc. In this study, type III collagen has been isolated from normal human and bovine intervertebral disc and immunolocalized in sections of rat, sheep, bovine and 'normal' human intervertebral disc of various ages. Staining with antisera to type III collagen is localized primarily around the cells. Results indicate that cells of the disc sit in 'chondrons', similar to those seen in the deep and mid zones of articular cartilage. We suggest that type III collagen is present in the intervertebral disc and hypothesize that it may be involved in the organization of the pericellular environment, perhaps linking the chondron capsule to the interterritorial matrix.     

The internal mechanics of the intervertebral disc under cyclic loading

The mechanics of the intervertebral disc (IVD) under cyclic loading are investigated via a one-dimensional poroelastic model and experiment. The poroelastic model, based on that of Biot (J. Appl. Phys. 12 (1941) 155; J. Appl. Mech. 23 (1956) 91), includes a power-law relation between porosity and permeability, and a linear relation between the osmotic potential and solidity. The model was fitted to experimental data of the unconfined IVD undergoing 5 cyclic loads of 20 min compression by an applied stress of 1MPa, followed by 40 min expansion. To obtain a good agreement between experiment and theory, the initial elastic deformation of the IVD, possibly associated with the bulging of the IVD into the vertebral bodies or laterally, was removed from the experimental data. Many combinations of the permeability-porosity relationship with the initial osmotic potential (pi(i)) were investigated, and the best-fit parameters for the aggregate modulus (H(A)) and initial permeability (k(i)) were determined. The values of H(A) and k(i) were compared to literature values, and agreed well especially in the context of the adopted high-stress testing regime, and the strain related permeability in the model.     

Reduced nucleus pulposus glycosaminoglycan content alters intervertebral disc dynamic viscoelastic mechanics

The intervertebral disc functions over a range of dynamic loading regimes including axial loads applied across a spectrum of frequencies at varying compressive loads. Biochemical changes occurring in early degeneration, including reduced nucleus pulposus glycosaminoglycan content, may alter disc mechanical behavior and thus may contribute to the progression of degeneration. The objective of this study was to determine disc dynamic viscoelastic properties under several equilibrium loads and loading frequencies, and further, to determine how reduced nucleus glycosaminoglycan content alters dynamic mechanics. We hypothesized that (1) dynamic stiffness would be elevated with increasing equilibrium load and increasing frequency, (2) the disc would behave more elastically at higher frequencies, and finally, (3) dynamic stiffness would be reduced at low equilibrium loads under all frequencies due to nucleus glycosaminoglycan loss. We mechanically tested control and chondroitinase ABC injected rat lumbar motion segments at several equilibrium loads using oscillatory loading at frequencies ranging from 0.05 to 5 Hz. The rat lumbar disc behaved non-linearly with higher dynamic stiffness at elevated compressive loads irrespective of frequency. Phase angle was not affected by equilibrium load, although it decreased as frequency was increased. Reduced glycosaminoglycan decreased dynamic stiffness at low loads but not at high equilibrium loads and led to increased phase angle at all loads and frequencies. The findings of this study demonstrate the effect of equilibrium load and loading frequencies on dynamic disc mechanics and indicate possible mechanical mechanisms through which disc degeneration can progress.     

Role of load history in intervertebral disc mechanics and intradiscal pressure generation

Solid–fluid interactions play an important role in mediating viscoelastic behaviour of biological tissues. In the intervertebral disc, water content is governed by a number of factors, including age, disease and mechanical loads, leading to changes in stiffness characteristics. We hypothesized that zonal stress distributions depend on load history, or the prior stresses experienced by the disc. To investigate these effects, rat caudal motion segments were subjected to compressive creep biomechanical testing in vitro using a protocol that consisted of two phases: a Prestress Phase (varied to represent different histories of load) followed immediately by an Exertion Phase, identical across all Prestress groups. Three analytical models were used to fit the experimental data in order to evaluate load history effects on gross and zonal disc mechanics. Model results indicated that while gross transient response was insensitive to load history, there may be changes in the internal mechanics of the disc. In particular, a fluid transport model suggested that the role of the nucleus pulposus in resisting creep during Exertion depended on Prestress conditions. Separate experiments using similarly defined load history regimens were performed to verify these predictions by measuring intradiscal pressure with a fibre optic sensor. We found that the ability for intradiscal pressure generation was load history-dependent and exhibited even greater sensitivity than predicted by analytical models. A 0.5?MPa Exertion load resulted in 537.2?kPa IDP for low magnitude Prestress compared with 373.7?kPa for high magnitude Prestress. Based on these measurements, we developed a simple model that may describe the pressure-shear environment in the nucleus pulposus. These findings may have important implications on our understanding of how mechanical stress contributes to disc health and disease etiology.     

Effect of intervertebral disc degeneration on disc cell viability: a numerical investigation

Degeneration of the intervertebral disc may be initiated and supported by impairment of the nutrition processes of the disc cells. The effects of degenerative changes on cell nutrition are, however, only partially understood. In this work, a finite volume model was used to investigate the effect of endplate calcification, water loss, reduction of disc height and cyclic mechanical loading on the sustainability of the disc cell population. Oxygen, lactate and glucose diffusion, production and consumption were modelled with non-linear coupled partial differential equations. Oxygen and glucose consumption and lactate production were expressed as a function of local oxygen concentration, pH and cell density. The cell viability criteria were based on local glucose concentration and pH. Considering a disc with normal water content, cell death was initiated in the centre of the nucleus for oxygen, glucose, and lactate diffusivities in the cartilaginous endplate below 20% of the physiological values. The initial cell population could not be sustained even in the non-calcified endplates when a reduction of diffusion inside the disc due to water loss was modelled. Alterations in the disc shape such as height loss, which shortens the transport route between the nutrient sources and the cells, and cyclic mechanical loads, could enhance cell nutrition processes.     

Ultrastructural observations on collagen and proteoglycans in the annulus fibrosus of the intervertebral disc

Replicas of freeze-fractured collagen fibrils of peripheral and central parts of the annulus fibrosus of bovine intervertebral discs show microfibrils which run either arranged in parallel or in a helix with an inclination-angle ranging from 4 degrees to 8 degrees. According to results of freeze-fracutred tissues, thin sections of specimens treated with 4M guanidinium chloride show collagen fibrils with a parallel or a slightly wavy microfibrillar packing. Thin sections of specimens treated with alcian blue diluted in MgCl2 critical electrolyte solutions reveal interfibrillar proteoglycan particles with a filamentous shape in the peripheral zones of the annulus fibrosus and a predominant leaf-like appearance in the inner ones. These observations are discussed with reference to previous data concerning the variation in composition from the peripheral to the inner parts of the annulus fibrosus.     

The role of the nucleus pulposus in neutral zone human lumbar intervertebral disc mechanics

To study the effect of denucleation on the mechanical behavior of the human lumbar intervertebral disc through a 2mm incision, two groups of six human cadaver lumbar spinal units were tested in axial compression, axial rotation, lateral bending and flexion/extension after incremental steps of "partial" denucleation. Neutral zone, range of motion, stiffness, intradiscal pressure and energy dissipation were measured; the results showed that the contribution of the nucleus pulposus to the mechanical behavior of the intervertebral disc was more dominant through the neutral zone than at the farther limits of applied loads and moments.     

Novel lap test determines the mechanics of delamination between annular lamellae of the intervertebral disc

Delamination between lamellae of the annulus fibrosus is a crucial stage of intervertebral disc herniation, and to better understand the mechanics of the delamination process, a novel lap test was devised. Specimens consisting of two adjacent, naturally bonded lamellae were obtained from the cervical region of frozen porcine spines. They were cut into specimens nominally 3.5 mm wide by 7 mm long and tabs of the deep and superficial layers were removed from opposite ends of the specimens so that a 4.5–5.0 mm long intact interface remained between the lamellae. Specimens were mounted in a BioTester tensile instrument using BioRake attachments having 5 sharpened points side-by-side, and they were strained at 2%/s. Force–time curves were obtained and, using tracking software, a detailed map was made of the time course of the displacements within the specimens. Extensibility of the lamellae themselves was found to substantially complicate interpretation of the data. The experiments, together with mathematical analyses and finite element models, show that much of the shear load is transferred between lamellae at the ends of the bonded region, a finding of clinical importance. The inter-lamellae bond was found to have a peak strength of 0.30±0.05 N/mm of specimen width (not to be confused with lap length), and the remarkable ability to carry substantial load even when lamellae had displaced up to 10 mm relative to each other.     

Degeneration of the intervertebral disc

The intervertebral disc is a cartilaginous structure that resembles articular cartilage in its biochemistry, but morphologically it is clearly different. It shows degenerative and ageing changes earlier than does any other connective tissue in the body. It is believed to be important clinically because there is an association of disc degeneration with back pain. Current treatments are predominantly conservative or, less commonly, surgical; in many cases there is no clear diagnosis and therapy is considered inadequate. New developments, such as genetic and biological approaches, may allow better diagnosis and treatments in the future.     

Diffusion of antibiotics in intervertebral disc

Delivering charged antibiotics to the intervertebral disc is challenging because of the avascular, negatively charged extracellular matrix (ECM) of the tissue. The purpose of this study was to measure the apparent diffusion coefficient of two clinically relevant, charged antibiotics, vancomycin (positively charged) and oxacillin (negatively charged) in IVD. A one-dimensional steady state diffusion experiment was employed to measure the apparent diffusion coefficient of the two antibiotics in bovine coccygeal annulus fibrosus (AF) tissue. The averaged apparent diffusion coefficient for vancomycin under 20% compressive strain was 7.94 ± 2.00 × 10⁻¹² m²/s (n = 10), while that of oxacillin was 2.26 ± 0.68 × 10⁻¹⁰ m²/s (n = 10). A student’s t-test showed that the diffusivity of vancomycin was significantly lower than that of oxacillin. This finding may be attributed to two factors: solute size and possible binding effects. Vancomycin is approximately 3 times larger in molecular weight than oxacillin, meaning that steric hindrance likely plays a role in the slower transport. Reversible binding between positive vancomycin and the negative ECM could also slow down the rate of diffusion. Therefore, more investigation is necessary to determine the specific relationship between net charge on antibiotic and diffusion coefficients in IVD. This study provides essential quantitative information regarding the transport rates of antibiotics in the IVD, which is critical in using computational modeling to design effective strategies to treat disc infection.     

Type VI collagen of the intervertebral disc. Biochemical and electron-microscopic characterization of the native protein.

The collagen framework of the intervertebral disc contains two major fibril-forming collagens, types I and II. Smaller amounts of other types of collagen are also present. On examination of the nature and distribution of these minor collagens within bovine disc tissue, type VI collagen was found to be unusually abundant. It accounted for about 20% of the total collagen in calf nucleus pulposus, and about 5% in the annulus fibrosus. It was discovered by serially digesting disc tissue with chondroitin ABC lyase and Streptomyces hyaluronidase that native covalent polymers of type VI collagen could be extracted. Electron micrographs of this material prepared by rotary shadowing revealed the characteristic dimensions of tetramers and double tetramers of type VI molecules, with their central rods and terminal globular domains. Molecular-sieve column chromatography on agarose under non-reducing non-denaturing conditions gave a series of protein peaks with molecular sizes equivalent to the tetramer, double tetramer and higher multimers. On SDS/polyacrylamide-gel electrophoresis after disulphide cleavage, these fractions of type VI collagen all showed a main band at Mr 140,000 and four lesser bands between Mr 180,000 and 240,000. On electrophoresis without disulphide cleavage in agarose/2.4% polyacrylamide only dimeric (six chains) and tetrameric (12 chains) forms of type VI molecules were present. The ability to extract all the type VI collagen of the tissue in 4 M-guanidinium chloride, and absence of aldehyde-mediated cross-linking residues on direct analysis, showed that, in contrast with most matrix collagens, type VI collagen does not function as a covalently cross-linked structural polymer.     

Pathophysiology of the human intervertebral disc

Intervertebral disc degeneration is a common invalidating disorder that can affect the musculoskeletal apparatus in both younger and older ages. The chief component of the intervertebral disc is the highly organized extracellular matrix; maintenance of its organization is essential for correct spinal mechanics. The matrix components, mainly proteoglycans and collagens, undergo a slow and continuous cell-mediated turnover process that enables disc cells to adapt their environment to external stimuli. Cellular senescence and a history of chronic abnormal loading can upset this balance, leading to progressive tissue failure that results in disc degeneration. Although biological treatment approaches to disc repair are still far to come, advances in our understanding of disc biochemistry and in defining the role of genetic inheritance have provided a starting point for developing new concepts in the diagnosis, therapy and prevention of disc degeneration.