The challenge and advancement of annulus fibrosus tissue engineering.
BACKGROUND
Intervertebral disc degeneration, a main cause of back pain, is an endemic problem and a big economic burden for the health care system. Current treatments are symptom relieving but do not address underlying problems-biological and structural deterioration of the disc. Tissue engineering is an emerging approach for the treatment of intervertebral disc degeneration since it restores the functionality of native tissues. Although numerous studies have focused on the nucleus pulposus tissue engineering and achieved successes in laboratory settings, disc tissue engineering without annulus fibrosus for the end stage of disc degeneration is deemed to fail. The purpose of this article is to review the advancement of annulus fibrosus tissue engineering.


METHODS
Relevant articles regarding annulus fibrosus tissue engineering were identified in PubMed and Medline databases.


RESULTS
The ideal strategy for disc regeneration is to restore the function and integrity of the disc by using biomaterials, native matrices, growth factors, and cells that producing matrices. In the past decades there are tremendous advancement in annulus fibrosus tissue engineering including cell biology, biomaterials, and whole disc replacement. The recent promising results on whole disc tissue engineering-a composite of annulus fibrosus and nucleus pulposus-make the tissue engineering approach more appealing.


CONCLUSIONS
Despite the promising results in disc tissue engineering, there is still much work to be done regarding the clinical application.
Department of Orthopaedic Surgery, University of Virginia, Hospital Drive, Cobb Hall B039, P.O. Box 800374, 22908, Charlottesville, VA, USA.
Li
L
Jin
Adam L
AL
Shimmer
Xudong
X
Li
D001672:Biocompatible Materials; D006801:Humans; D007403:Intervertebral Disc / Q000502:physiology* / Q000601:surgery; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D012038:Regeneration / Q000502:physiology*; D023822:Tissue Engineering / Q000379:methods*
D001672:Biocompatible Materials