title: Treatment of the degenerated intervertebral disc; closure, repair and regeneration of the annulus fibrosus.
abstract: Degeneration of the intervertebral disc (IVD) and disc herniation are two causes of low back pain. The aetiology of these disorders is unknown, but tissue weakening, which primarily occurs due to inherited genetic factors, ageing, nutritional compromise and loading history, is the basic factor causing disc degeneration. Symptomatic disc herniation mainly causes radicular pain. Current treatments of intervertebral disc degeneration and low back pain are based on alleviating the symptoms and comprise administration of painkillers or surgical methods such as spinal fusion. None of these methods is completely successful. Current research focuses on regeneration of the IVD and particularly on regeneration of the nucleus pulposus. Less attention has been directed to the repair or regeneration of the annulus fibrosus, although this is the key to successful nucleus pulposus, and therewith IVD, repair. This review focuses on the importance of restoring the function of the annulus fibrosus, as well as on the repair, replacement or regeneration of the annulus fibrosus in combination with restoration of the function of the nucleus pulposus, to treat low back pain.
authors.affiliation: University of Groningen, University Medical Center Groningen, W. J. Kolff Institute, Department of Biomedical Engineering, Groningen, The Netherlands.|MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Sharifi
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Orthopaedic Surgery, Groningen, The Netherlands.
authors.forename: Sjoerd K
authors.initials: SK
authors.lastname: Bulstra
authors.affiliation: University of Groningen, University Medical Center Groningen, W. J. Kolff Institute, Department of Biomedical Engineering, Groningen, The Netherlands.|MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Dirk W
authors.initials: DW
authors.lastname: Grijpma
authors.affiliation: University of Groningen, University Medical Center Groningen, W. J. Kolff Institute, Department of Biomedical Engineering, Groningen, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Kuijer
mesh_terms: D001672:Biocompatible Materials; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000473:pathology; D055959:Intervertebral Disc Degeneration / Q000503:physiopathology / Q000601:surgery*; D017116:Low Back Pain / Q000601:surgery; D023822:Tissue Engineering
chemical_list: D001672:Biocompatible Materials
keywords: annulus fibrosus; biomaterials; intervertebral disc; low back pain; review; spine; tissue engineering