Influence of experimental protocols on the mechanical properties of the intervertebral disc in unconfined compression

The lack of standardization in experimental protocols for unconfined compression tests of intervertebral discs (IVD) tissues is a major issue in the quantification of their mechanical properties. Our hypothesis is that the experimental protocols influence the mechanical properties of both annulus fibrosus and nucleus pulposus. IVD extracted from bovine tails were tested in unconfined compression stress-relaxation experiments according to six different protocols, where for each protocol, the initial swelling of the samples and the applied preload were different. The Young's modulus was calculated from a viscoelastic model, and the permeability from a linear biphasic poroviscoelastic model. Important differences were observed in the prediction of the mechanical properties of the IVD according to the initial experimental conditions, in agreement with our hypothesis. The protocol including an initial swelling, a 5% strain preload, and a 5% strain ramp is the most relevant protocol to test the annulus fibrosus in unconfined compression, and provides a permeability of 5.0 ± 4.2e(-14)m(4)/N[middle dot]s and a Young's modulus of 7.6 ± 4.7 kPa. The protocol with semi confined swelling and a 5% strain ramp is the most relevant protocol for the nucleus pulposus and provides a permeability of 10.7 ± 3.1 e(-14)m(4)/N[middle dot]s and a Young's modulus of 6.0 ± 2.5 kPa.     

The effect of sustained compression on oxygen metabolic transport in the intervertebral disc decreases with degenerative changes

Intervertebral disc metabolic transport is essential to the functional spine and provides the cells with the nutrients necessary to tissue maintenance. Disc degenerative changes alter the tissue mechanics, but interactions between mechanical loading and disc transport are still an open issue. A poromechanical finite element model of the human disc was coupled with oxygen and lactate transport models. Deformations and fluid flow were linked to transport predictions by including strain-dependent diffusion and advection. The two solute transport models were also coupled to account for cell metabolism. With this approach, the relevance of metabolic and mechano-transport couplings were assessed in the healthy disc under loading-recovery daily compression. Disc height, cell density and material degenerative changes were parametrically simulated to study their influence on the calculated solute concentrations. The effects of load frequency and amplitude were also studied in the healthy disc by considering short periods of cyclic compression. Results indicate that external loads influence the oxygen and lactate regional distributions within the disc when large volume changes modify diffusion distances and diffusivities, especially when healthy disc properties are simulated. Advection was negligible under both sustained and cyclic compression. Simulating degeneration, mechanical changes inhibited the mechanical effect on transport while disc height, fluid content, nucleus pressure and overall cell density reductions affected significantly transport predictions. For the healthy disc, nutrient concentration patterns depended mostly on the time of sustained compression and recovery. The relevant effect of cell density on the metabolic transport indicates the disturbance of cell number as a possible onset for disc degeneration via alteration of the metabolic balance. Results also suggest that healthy disc properties have a positive effect of loading on metabolic transport. Such relation, relevant to the maintenance of the tissue functional composition, would therefore link disc function with disc nutrition.     

Nutrient distribution and metabolism in the intervertebral disc in the unloaded state: A parametric study

A 2-D finite element model for the intervertebral disc in which quadriphasic theory is coupled to the transport of solutes involved in cellular nutrition was developed for investigating the main factors contributing to disc degeneration. Degeneration is generally considered to result from chronic disc cell nutrition insufficiency, which prevents the cells from renewing the extracellular matrix and thus leads to the loss of proteoglycans. Hence, the osmotic power of the disc is decreased, causing osmomechanical impairments. Cellular metabolism depends strongly on the oxygen, lactate and glucose concentrations and on pH in the disc. To study the diffusion of these solutes in a mechanically or osmotically loaded disc, the osmomechanical and diffusive effects have to be coupled. The intervertebral disc is modeled here using a plane strain formulation at the equilibrium state under physiological conditions after a long rest period (called unloaded state). The correlations between solute distribution and various properties of healthy and degenerated discs are investigated. The numerical simulation shows that solute distribution in the disc depends very little on the elastic modulus or the proteoglycan concentration but greatly on the porosity, diffusion coefficient and endplate diffusion area. This coupled model therefore opens new perspectives for investigating intervertebral disc degeneration mechanisms.     

A mechanical model for the human intervertebral disc

Stress relaxation experiments were performed on specimens from a human intervertebral disc. Specimens were made from the nucleus pulposus and from the external lamellae of the anulus fibrosus in two different orientations. Tests were run with varying moisture content so as to develop a relaxation master curve. A model was developed based on the experimental data. It was found that the short term master curve for the lamellae of the anulus and nucleus are similar, whereas the long term rubbery plateau is different between the lamellae and the nucleus. It was also established that the master curves for different lamellae and the nucleus were shifted relative to each other in the time domain due to changes in water content. The average relaxation modulus of the whole disc was obtained by averaging the properties between the anulus and nucleus. This model was then used for studies of Schmorl's nodes, of degenerated discs and for circumstances in which hydration is considered to be important.     

Mechanisms for mechanical damage in the intervertebral disc annulus fibrosus

Intervertebral disc degeneration results in disorganization of the laminate structure of the annulus that may arise from mechanical microfailure. Failure mechanisms in the annulus were investigated using composite lamination theory and other analyses to calculate stresses in annulus layers, interlaminar shear stress, and the region of stress concentration around a fiber break. Scanning electron microscopy (SEM) was used to evaluate failure patterns in the annulus and evaluate novel structural features of the disc tissue. Stress concentrations in the annulus due to an isolated fiber break were localized to approximately 5 microm away from the break, and only considered a likely cause of annulus fibrosus failure (i.e., radial tears in the annulus) under extreme loading conditions or when collagen damage occurs over a relatively large region. Interlaminar shear stresses were calculated to be relatively large, to increase with layer thickness (as reported with degeneration), and were considered to be associated with propagation of circumferential tears in the annulus. SEM analysis of intervertebral disc annulus fibrosus tissue demonstrated a clear laminate structure, delamination, matrix cracking, and fiber failure. Novel structural features noted with SEM also included the presence of small tubules that appear to run along the length of collagen fibers in the annulus and a distinct collagenous structure representative of a pericellular matrix in the nucleus region.     

The composition and protein metabolism in the immature rabbit intervertebral disc

The nucleus pulposus (NP) and annulus fibrosus (AF) of immature rabbit intervertebral discs (IVD) have been subjected to the dissociative extraction procedure of Sajdera and Hascall (1969). The soluble, insoluble and unextracted fractions so obtained were analysed for total nitrogen, collagen, tyrosine, uronic acid, hexosamine and sialic acid content. A high proportion of non-collagenous protein, hexose and sialic acid in the NP insoluble fraction suggests the presence of glycopeptides associated with collagen and/or proteoglycans. The levels of proteoglycan in the soluble NP and AF fraction are similar. Immature (soluble) collagen, however, resides largely in the AF region. The metabolism of rabbit IVD protein components was also investigated both chemically and by autoradiography. L-Tyrosine-3,5-H3 was administered intraperitoneally (3 mc/kg) to 4 week-old rabbits. Animals were sacrificed at various time intervals and the harvested tissues extracted as before and lumbar discs collected. The levels of L-Tyrosine-3,5-H3 in the NP and AF insoluble and soluble fractions were determined using a tritium scintillation counting procedure and localisation by autoradiography. Pronounced extracellular activity of proteoglycan and glycoprotein is not evident before 24 hours. Soluble collagen, however, is synthesized and dispersed within 4 hours of isotope administration.     

Skin-flap metabolism in rats: oxygen consumption and lactate production

Overall glucose metabolism was evaluated by measuring the rate of oxygen consumption (QO2) and lactate production in the pedicle skin flaps of rats. Skin flaps exhibited increases in QO2 and lactate production in vitro. The distal portion of the flap is characterized by a greater deposition of glucose to lactate during the initial 3 days following flap elevation. The contribution of glycolysis and of the oxidative pathways to glucose metabolism in skin flaps approximates that in normal skin on day 7 postoperatively.     

Effect of endplate calcification and mechanical deformation on the distribution of glucose in intervertebral disc: a 3D finite element study

The intervertebral disc (IVD) is avascular, receiving nutrition from surrounding vasculature. Theoretical modelling can supplement experimental results to understand nutrition to IVD more clearly. A new, 3D finite element model of the IVD was developed to investigate effects of endplate calcification and mechanical deformation on glucose distributions in IVD. The model included anatomical disc geometry, non-linear coupling of cellular metabolism with pH and oxygen concentration and strain-dependent properties of the extracellular matrix. Calcification was simulated by reducing endplate permeability (～79%). Mechanical loading was applied based on in vivo disc deformation during the transition from supine to standing positions. Three static strain conditions were considered: supine, standing and weight-bearing standing. Minimum glucose concentrations decreased 45% with endplate calcification, whereas disc deformation led to a 4.8-63% decrease, depending on the endplate condition (i.e. normal vs. calcified). Furthermore, calcification more strongly affected glucose concentrations in the nucleus compared to the annulus fibrous region. This study provides important insight into nutrient distributions in IVD under mechanical deformation.     

Hyaluronan distribution in the human and canine intervertebral disc and cartilage endplate

A biotinylated complex of aggrecan G1-domain and link protein was used to characterize the distribution of hyaluronan in paraffin-embedded sections of adult human and canine intervertebral disc and cartilage endplate. Limited chondroitinase ABC and trypsin digestions of the sections before staining was utilized to expose hyaluronan potentially masked by aggrecan. Hyaluronan concentration and hyaluronan to uronic acid ratio in different parts of the discs were measured as a background for the histological analysis.Hyaluronan staining was strong in the nucleus pulposus and inner parts of annulus fibrosus of both species, corroborated by biochemical assays of the same compartments. Particularly in human samples, hyaluronan in the interterritorial matrix of nucleus pulposus and annulus fibrosus was readily accessible to the probe without enzyme treatments. In contrast, the cell-associated hyaluronan signal was enhanced after trypsin or limited chondroitinase ABC-treatment of the sections, suggesting that pericellular hyaluronan was more masked by aggrecan than in the distant matrix. A puzzling feature of canine cartilage endplate cells was their intensive cell-associated hyaluronan signal, part of which appeared intracellular. Hyaluronan was abundant between the collagenous lamellae in annulus fibrosus, perhaps important in the plasticity of this tissue.     

Quantitative MRI water content mapping of porcine intervertebral disc during uniaxial compression

Background: Intervertebral disc (IVD) diseases are major public health problem in industrialized countries where they affect a large proportion of the population. In particular, IVD degeneration is considered to be one of the leading causes of pain consultation and sick leave. The aim of this study was to develop a new method for assessing the functionality of IVD in order to diagnose IVD degeneration. Methods: For this purpose, we have designed a specific device that enables to mechanically load porcine IVD ex vivo in the 4.7-Tesla horizontal superconducting magnet of a magnetic resonance (MR) scanner. Proton density weighted imaging (ρ_H-MRI) of the samples was acquired. Findings: The post-processing on MR images allowed (1) to reconstruct the 3D deformation under a known mechanical load and (2) to infer the IVD porosity assuming an incompressible poroelastic model. Interpretation: This study demonstrates the ability to follow the change in morphology and hydration of an IVD using MR measurements, thereby providing valued information for a better understanding of IVD function.     

Influence of material properties on the mechanical behaviour of the L5-S1 intervertebral disc in compression: a nonlinear finite element study

A simple finite element model of the L₅-S₁ intervertebral disc body has been constructed; it is circular and symmetrical about the sagittal plane. The annulus fibrosus of the model was idealized as an inhomogeneous composite of an isotropic ground substance, reinforced by helically oriented collagen fibres so that the model has six different structural components namely: cortical bone, cancellous bone, cartilaginous endplates, nucleus pulposus, ground substance and collagen fibres. A sensitivity analysis of the material properties of each structural component was carried out by varying those properties for one structural component at a time and evaluating the changes in the biomechanical response to compressive displacements. Experimentally available relations between the applied compressive force and the vertical displacements, the nucleus pulposus pressure increase and the disc lateral bulge were used to evaluate the biomechanical responses for each set of material properties. Results showed that both the Poisson's ratio and the Young's modulus of the ground substance play an important role in the prediction of the biomechanical response.     

Effects of pulsed electromagnetic field on intervertebral disc cell apoptosis in rats

Despite numerous studies on pulsed electromagnetic field (PEMF) application, its effects of PEMF on intervertebral disc (IVD) have not yet been investigated in vivo. Accordingly, the effects of PEMF upon IVD in rats were evaluated through molecular surveys. Rats were divided into six groups: Group I and II were exposed to low and high frequency of PEMF (LF and HF, respectively). Group III and IV underwent induced disc degeneration and were exposed to low and high frequency of PEMF (LF/IDD and HF/IDD, respectively). Group V underwent induced disc degeneration (IDD), and group VI was control. The values of caspase 3, Bax, Bcl-2 and β-actin band density, as cell apoptotic markers, were obtained from band densitometry. Our results showed that the value of cleaved caspase-3 of cells and Bax/Bcl-2 ratio in IDD group increased significantly compared to the control group (p?p?相似文献   

Computation of coupled diffusion of oxygen, glucose and lactic acid in an intervertebral disc

The present numerical study aims to investigate the disc nutrition and factors affecting it by evaluating the concentrations of oxygen, glucose and lactic acid in the disc while accounting for the coupling between these species via the pH level in the tissue and the nonlinear concentration-consumption (for glucose and oxygen) and concentration-production (for lactate) relations. The effects of changes in the endplate exchange area (EA) adjacent to the nucleus or the inner annulus for the transport of nutrients and in the disc geometry as well as tissue diffusivities under static compression loading on species concentrations are also studied. Moreover, alterations in solute diffusion following a central endplate fracture are investigated. An axisymmetric geometry with four distinct regions is considered. Supply sources are assumed at the outer annulus periphery and disc endplates. Coupling between different solutes, pH level, endplate disruptions (calcifications and fractures) and mechanical loads substantially influenced the distribution of nutrients throughout the disc as well as the magnitude and location of critical concentrations; maximum for the lactic acid and minimum for oxygen and glucose. In cases with loss of endplate permeability and/or disruptions therein, as well as changes in geometry and fall in diffusivity associated with fluid expression, the nutrient concentrations could fall to levels inadequate to maintain cellular activity or viability, thus initiating or accelerating disc degeneration.     

Temporal changes of mechanical signals and extracellular composition in human intervertebral disc during degenerative progression

In this study, a three-dimensional finite element model was used to investigate the changes in tissue composition and mechanical signals within human lumbar intervertebral disc during the degenerative progression. This model was developed based on the cell-activity coupled mechano-electrochemical mixture theory. The disc degeneration was simulated by lowering nutrition levels at disc boundaries, and the temporal and spatial distributions of the fixed charge density, water content, fluid pressure, Von Mises stress, and disc deformation were analyzed. Results showed that fixed charge density, fluid pressure, and water content decreased significantly in the nucleus pulposus (NP) and the inner to middle annulus fibrosus (AF) regions of the degenerative disc. It was found that, with degenerative progression, the Von Mises stress (relative to that at healthy state) increased within the disc, with a larger increase in the outer AF region. Both the disc volume and height decreased with the degenerative progression. The predicted results of fluid pressure change in the NP were consistent with experimental findings in the literature. The knowledge of the variations of temporal and spatial distributions of composition and mechanical signals within the human IVDs provide a better understanding of the progression of disc degeneration.     

Effect of overload on changes in mechanical and structural properties of the annulus fibrosus of the intervertebral disc

The research focussed on analysing structural and mechanical properties in the intervertebral disc (IVD), caused by long-term cyclic loading. Spinal motion segments were divided into two groups: the control (C), and the group in which it was analysed the impact of posterior column in the load-bearing system of the spine—specimens with intact posterior column (IPC) and without posterior column (WPC). To evaluate the structural and mechanical changes, the specimens were tested with simulation of 100,000 compression-flexion load cycles after which it was performed macroscopic analysis. Mechanical properties of the annulus fibrosis (AF) from the anterior and posterior regions of the IVD were tested at the uniaxial tension test. The stiffness coefficient values were statistically 32% higher in the WPC group (110 N/mm) than in the IPC (79 N/mm). The dynamics of increase in this parameter does not correspond with the course of decrease in height loss. WPC segments revealed clear structural changes that mainly involve the posterior regions of the IVD (bulging and delamination with the effect of separation of collagen fibre bundles). Pathological changes also caused decreases in the value of stress in the AF. The greatest changes in the stress value about group C (7.43 ± 4.49 MPa) were observed in the front part of the fibrous ring, where this value was for IPC 4.49 ± 4.78 MPa and WPC 2.56 ± 1.01 MPa. The research indicates that the applied load model allows simulating damage that occurs in pathological IVD. And the posterior column’s presence affects this change’s dynamics, structural and mechanical properties of AF.

     

MicroRNA in intervertebral disc degeneration

Aetiology of intervertebral disc degeneration (IDD) is complex, with genetic, developmental, biochemical and biomechanical factors contributing to the disease process. It is becoming obvious that epigenetic processes influence evolution of IDD as strongly as the genetic background. Deregulated phenotypes of nucleus pulposus cells, including differentiation, migration, proliferation and apoptosis, are involved in all stages of progression of human IDD. Non‐coding RNAs, including microRNAs, have recently been recognized as important regulators of gene expression. Research into roles of microRNAs in IDD has been very active over the past 5 years. Our review summarizes current research enlightenment towards understanding roles of microRNAs in regulating nucleus pulposus cell functions in IDD. These exciting findings support the notion that specific modulation of microRNAs may represent an attractive approach for management of IDD.     

Effects of training at and above the lactate threshold on the lactate threshold and maximal oxygen uptake

Thirty-three college women (mean age = 21.8 years) participated in a 5 d X wk-1, 12 week training program. Subjects were randomly assigned to 3 groups, above lactate threshold (greater than LT) (N = 11; trained at 69 watts above the workload associated with LT), = LT (N = 12; trained at the work load associated with LT) and control (C) (N = 10). Subjects were assessed for VO2max, VO2LT, VO2LT/VO2max, before and after training, using a discontinuous 3 min incremental (starting at 0 watts increasing 34 watts each work load) protocol on a cycle ergometer (Monark). Respiratory gas exchange measures were determined using standard open circuit spirometry while LT was determined from blood samples taken immediately following each work load from an indwelling venous catheter located in the back of a heated hand. Body composition parameters were determined before and after training via hydrostatic weighing. Training work loads were equated so that each subject expended approximately 1465 kJ per training session (Monark cycle ergometer) regardless of training intensity. Pretraining, no significant differences existed between groups for any variable. Post training the greater than LT group had significantly higher VO2max (13%), VO2LT (47%) and VO2LT/VO2max (33%) values as compared to C (p less than .05). Within group comparisons revealed that none of the groups significantly changed VO2max as a result of training, only the greater than LT group showed a significant increase in VO2LT (48%) (p less than .05), while both the = LT and greater than LT group showed significant increases in VO2LT/VO2max (= LT 16%, greater than LT 42% (p less than .05)).(ABSTRACT TRUNCATED AT 250 WORDS)