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The intervertebral disc is a complex structure that separates opposing vertebrae, permits a wide range of motion, and accommodates high biomechanical forces. Disc degeneration leads to a loss of function and is often associated with excruciating pain. Written by leading scientists and clinicians, the first part of the book provides a review of the basic biology of the disc in health and disease. The second part considers strategies to mitigate the effects of disc degeneration and discusses the possibility of engineering replacement tissues. The final section is devoted to approaches to model normal development and elucidate the pathogenesis of degenerative disc disease using animal, organ and cell culture techniques. The book bridges the gap between the basic and clinical sciences; the target audience includes basic scientists, orthopaedists and neurologists, while at the same time appealing to the needs of graduate students, medical students, interns and fellows.
First Published in 1988, this book documents the role, biology, and structure of the Intervertebral Disc. Carefully compiled and filled with a vast repertoire of notes, diagrams, and references this book serves as a useful reference for Students of Medicine, Chiropractors, and other practitioners in their respective fields.
First Published in 1988, this book documents the role, biology, and structure of the Intervertebral Disc. Carefully compiled and filled with a vast repertoire of notes, diagrams, and references this book serves as a useful reference for Students of Medicine, Chiropractors, and other practitioners in their respective fields.
Bogduk aims to provide a foundation of knowledge upon which an understanding of the various treatment and therapy techniques of the different specialities involved can be built. This edition includes discussion of the sacrum and sacro-iliac joint.
Disorders related to the intervertebral disc (IVD) are common causes of morbidity and of severe life quality deterioration. IVD degeneration, although in many cases asymptomatic, is often the origin of painful neck and back diseases. In Western societies IVD related pain and disability account for enormous health care costs as a result of work absenteeism and thus lost production, disability benefits, medical and insurance expenses. Although only a small percentage of patients with disc disorders finally will undergo surgery, spinal surgery has been one of the fastest growing disciplines in the musculoskeletal field in recent years. Nevertheless, current treatment options are still a matter of controversial discussion. In particular, they hardly can restore normal spine biomechanics and prevent degeneration of adjacent tissues. While degeneration affects all areas of the IVD, the most constant and noticeable changes occur in the gel-like central part, the nucleus pulposus (NP). Recent emphasis has therefore been put in biological ways to regenerate the NP; however, there are a number of obstacles to overcome, considering the exceptional biological and biomechanical environment of this tissue. Different biological approaches such as molecular, gene, and cell based therapies have been investigated and have shown promising results in both in vitro and in vivo studies. Nonetheless, considerable hurdles still exist in their application for IVD regeneration in human patients. The choice of the cells and the choice of the cell carrier suitable for implantation pose major challenges for research and development activities. This lecture recapitulates the basics of IVD structure, function, and degeneration mechanisms. The first part reviews the recent progress in the field of disc and stem cell based regenerative approaches. In the second part, most appropriate biomaterials that have been evaluated as cell or molecule carrier to cope with degenerative disc disease are outlined. The potential and limitations of cell- and biomaterial-based treatment strategies and perspectives for future clinical applications are discussed. Table of Contents: Cell Therapy for Nucleus Pulposus Regeneration / Recent Advances in Biomaterial Based Tissue Engineering for Intervertebral Disc Regeneration
Low back pain is a common disorder in the clinical treatment of the Department of Orthopedics. Lumbar intervertebral disc degeneration is a main reason for the chronic pain and the process is difficult to reverse. Traditional treatment methods include conservative treatment and surgical treatment. Although the clinical symptoms caused by intervertebral disc degeneration can be alleviated to a certain extent, these treatment methods do not solve the fundamental issues and they also produce corresponding complications. The rise of tissue engineering technology and its applications in different fields have brought new ideas for the treatment of intervertebral disc degeneration. This book discusses the fundamentals as well as more recent developments in stem cell therapy and tissue engineering technology and offers an alternative for treating degeneration of intervertebral discs.
Disorders related to the intervertebral disc (IVD) are common causes of morbidity and of severe life quality deterioration. IVD degeneration, although in many cases asymptomatic, is often the origin of painful neck and back diseases. In Western societies IVD related pain and disability account for enormous health care costs as a result of work absenteeism and thus lost production, disability benefits, medical and insurance expenses. Although only a small percentage of patients with disc disorders finally will undergo surgery, spinal surgery has been one of the fastest growing disciplines in the musculoskeletal field in recent years. Nevertheless, current treatment options are still a matter of controversial discussion. In particular, they hardly can restore normal spine biomechanics and prevent degeneration of adjacent tissues. While degeneration affects all areas of the IVD, the most constant and noticeable changes occur in the gel-like central part, the nucleus pulposus (NP). Recent emphasis has therefore been put in biological ways to regenerate the NP; however, there are a number of obstacles to overcome, considering the exceptional biological and biomechanical environment of this tissue. Different biological approaches such as molecular, gene, and cell based therapies have been investigated and have shown promising results in both in vitro and in vivo studies. Nonetheless, considerable hurdles still exist in their application for IVD regeneration in human patients. The choice of the cells and the choice of the cell carrier suitable for implantation pose major challenges for research and development activities. This lecture recapitulates the basics of IVD structure, function, and degeneration mechanisms. The first part reviews the recent progress in the field of disc and stem cell based regenerative approaches. In the second part, most appropriate biomaterials that have been evaluated as cell or molecule carrier to cope with degenerative disc disease are outlined. The potential and limitations of cell- and biomaterial-based treatment strategies and perspectives for future clinical applications are discussed. Table of Contents: Cell Therapy for Nucleus Pulposus Regeneration / Recent Advances in Biomaterial Based Tissue Engineering for Intervertebral Disc Regeneration
This book provides a brief snapshot of recent research on the subject of intervertebral disc degeneration and how this specific organ could be regenerated. It provides stimuli to the reader in representing research from different angles in this cross-disciplinary field of spine surgeons, mechanical engineers and biologists. In particular, it is instructive as to how disc herniations could be successfully induced in vitro and, also, to how novel cell-based therapies using rare autochthonous stem cells could potentially be used in the future.
Richly illustrated throughout with actual tissue images, this innovative book shows that the soft-hard tissue junction is best understood in a biomechanical context. The authors describe their pioneering experimental methods, providing an essential structure-function framework for computational modelling, and thereby encouraging the development of more realistic, predictive models of this important tissue junction. Covering the three main musculoskeletal junctions of cartilage-bone, disc-vertebra, and ligament/tendon-bone, the relevant soft tissues are examined with respect to both their own inherent structure and their mode of integration with the hard tissue. The soft-hard tissue interface is explored with a focus on structural damage resulting from overloading, and its associated pathologies. Adopting a multiscale approach, ranging in structural resolution from the macro to fibril levels, this is a must-have guide to the field and an ideal resource for researchers seeking new and creative approaches for studying the joint and spine tissues.