Repair, regenerative and supportive therapies of the annulus fibrosus: achievements and challenges.
Lumbar discectomy is a very effective therapy for neurological decompression in patients suffering from sciatica due to hernia nuclei pulposus. However, high recurrence rates and persisting post-operative low back pain in these patients require serious attention. In the past decade, tissue engineering strategies have been developed mainly targeted to the regeneration of the nucleus pulposus (NP) of the intervertebral disc. Accompanying techniques that deal with the damaged annulus fibrous are now increasingly recognised as mandatory in order to prevent re-herniation to increase the potential of NP repair and to confine NP replacement therapies. In the current review, the requirements, achievements and challenges in this quickly emerging field of research are discussed.
Bron
Johannes Leendert
JL
Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands. jl.bron@vumc.nl
Helder
Marco N
MN
Meisel
Hans-Jorg
HJ
Van Royen
Barend J
BJ
Smit
Theodoor H
TH
D000818:Animals; D017586:Diskectomy / Q000379:methods; D051445:Fibrocartilage / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D048091:Guided Tissue Regeneration / Q000379:methods* / Q000639:trends; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D055502:Secondary Prevention; D023822:Tissue Engineering / Q000379:methods* / Q000639:trends