Biomaterials for Spinal Applications

A special issue of Journal of Functional Biomaterials (ISSN 2079-4983).

Deadline for manuscript submissions: closed (30 May 2018) | Viewed by 26030

Special Issue Editor


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Guest Editor
Institute of Surgical Technology & Biomechanics, University of Bern, Bern, Switzerland
Interests: hydrogels; organ culture; bioreactors; fibrin; fiber reinforced; intervertebral disc; growth factor slow release systems; electrospinning; 3D printing

Special Issue Information

Dear Colleagues,

This particular issue is devoted to presenting an overview of biomaterials currently in use in clinics or for future application for the spine and its tissues. Here, it is essential to distinguish between materials for the spinal cord and for the spine itself. In the latter, we can differentiate between materials to restore bone, i.e., the vertebrae but also for the intervertebral disc (IVD) or the cartilaginous endplate (CE). For the IVD and the CE, no satisfactory solutions have been proposed to date. The current approach in clinics for the treatment of discogenic back pain is discectomy followed by spinal fusion. For this procedure, currently, metal cages are most commonly used but also carbon-reinforced materials, which do not interfere with the magnetic resonance imaging (MRI) methodology, are becoming popular. For the restoration of the vertebrae for specialized applications such as for osteoporotic bone, there are some bone cement products currently on the market. Besides the IVD, decades of research has been carried out to restore mainly the centre of the disc, i.e., the gelatinous nucleus pulposus (NP), that retains water and provides the function of shock absorbance. In the case of IVD degeneration, disc height restoration is the primary target for regeneration or repair. It became evident that, for a successful solution, the repair or reinforcement of the outer fibrous ring of the IVD that holds the NP in place, i.e., the annulus fibrosus (AF), needs to be addressed in the first place to prevent leakage of native NP-tissue (herniation) or injected hydrogel material if successfully applied via an injection. This Special Issue will provide an overview of current research and materials and their mechanobiological requirements for this musculoskeletal research.

Prof. Dr. Benjamin Gantenbein
Guest Editor

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Keywords

  • annulus fibrosus repair
  • electrospinning
  • hydrogels for nucleus pulposus repair
  • growth factor release systems
  • natural materials
  • non- vs biodegradable materials
  • nucleus pulposus repair
  • silk for IVD repair
  • endplate repair
  • materials for spinal fusion

Published Papers (3 papers)

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Research

19 pages, 5529 KiB  
Article
Incorporation of Collagen and Hyaluronic Acid to Enhance the Bioactivity of Fibrin-Based Hydrogels for Nucleus Pulposus Regeneration
by Jennifer Gansau and Conor Timothy Buckley
J. Funct. Biomater. 2018, 9(3), 43; https://doi.org/10.3390/jfb9030043 - 10 Jul 2018
Cited by 11 | Viewed by 8680
Abstract
Hydrogels, such as fibrin, offer a promising delivery vehicle to introduce cells into the intervertebral disc (IVD) to regenerate damaged disc tissue as a potential treatment for low back pain. However, fibrin lacks key extracellular matrix (ECM) components, such as collagen (Col) and [...] Read more.
Hydrogels, such as fibrin, offer a promising delivery vehicle to introduce cells into the intervertebral disc (IVD) to regenerate damaged disc tissue as a potential treatment for low back pain. However, fibrin lacks key extracellular matrix (ECM) components, such as collagen (Col) and hyaluronan (HA), normally found in native nucleus pulposus (NP) tissue. The overall aim of this work was to create a fibrin-based hydrogel, by incorporating Col and HA into the matrix to enhance NP-like matrix accumulation using articular chondrocytes (CC). Firstly, we assessed the effect of fibrin concentrations on hydrogel stability, and the viability and proliferation kinetics of articular chondrocytes. Secondly, we investigated the effect of incorporating Col and HA to enhance NP-like matrix accumulation, and finally, examined the influence of various HA concentrations. Results showed that increasing fibrin concentration enhanced cell viability and proliferation. Interestingly, incorporation of HA promoted sGAG accumulation and tended to suppress collagen formation at higher concentrations. Taken together, these results suggest that incorporation of ECM components can enhance the bioactivity of fibrin-based hydrogels, which may help advance the clinical potential of commercial cell and biomaterial ventures in the treatment of IVD regeneration. Full article
(This article belongs to the Special Issue Biomaterials for Spinal Applications)
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17 pages, 3910 KiB  
Article
Genipin-Enhanced Fibrin Hydrogel and Novel Silk for Intervertebral Disc Repair in a Loaded Bovine Organ Culture Model
by Daniela A. Frauchiger, Rahel D. May, Ezgi Bakirci, Adel Tekari, Samantha C. W. Chan, Michael Wöltje, Lorin M. Benneker and Benjamin Gantenbein
J. Funct. Biomater. 2018, 9(3), 40; https://doi.org/10.3390/jfb9030040 - 24 Jun 2018
Cited by 44 | Viewed by 7140
Abstract
(1) Background: Intervertebral disc (IVD) repair represents a major challenge. Using functionalised biomaterials such as silk combined with enforced hydrogels might be a promising approach for disc repair. We aimed to test an IVD repair approach by combining a genipin-enhanced fibrin hydrogel with [...] Read more.
(1) Background: Intervertebral disc (IVD) repair represents a major challenge. Using functionalised biomaterials such as silk combined with enforced hydrogels might be a promising approach for disc repair. We aimed to test an IVD repair approach by combining a genipin-enhanced fibrin hydrogel with an engineered silk scaffold under complex load, after inducing an injury in a bovine whole organ IVD culture; (2) Methods: Bovine coccygeal IVDs were isolated from ~1-year-old animals within four hours post-mortem. Then, an injury in the annulus fibrosus was induced by a 2 mm biopsy punch. The repair approach consisted of genipin-enhanced fibrin hydrogel that was used to fill up the cavity. To seal the injury, a Good Manufacturing Practise (GMP)-compliant engineered silk fleece-membrane composite was applied and secured by the cross-linked hydrogel. Then, IVDs were exposed to one of three loading conditions: no load, static load and complex load in a two-degree-of-freedom bioreactor for 14 days. Followed by assessing DNA and matrix content, qPCR and histology, the injured discs were compared to an uninjured control IVD that underwent the same loading profiles. In addition, the genipin-enhanced fibrin hydrogel was further investigated with respect to cytotoxicity on human stem cells, annulus fibrosus, and nucleus pulposus cells; (3) Results: The repair was successful as no herniation could be detected for any of the three loading conditions. Disc height was not recovered by the repair DNA and matrix contents were comparable to a healthy, untreated control disc. Genipin resulted being cytotoxic in the in vitro test but did not show adverse effects when used for the organ culture model; (4) Conclusions: The current study indicated that the combination of the two biomaterials, i.e., genipin-enhanced fibrin hydrogel and an engineered silk scaffold, was a promising approach for IVD repair. Furthermore, genipin-enhanced fibrin hydrogel was not suitable for cell cultures; however, it was highly applicable as a filler material. Full article
(This article belongs to the Special Issue Biomaterials for Spinal Applications)
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10 pages, 1142 KiB  
Article
First Results of a New Vacuum Plasma Sprayed (VPS) Titanium-Coated Carbon/PEEK Composite Cage for Lumbar Interbody Fusion
by Sven Hoppe, Christoph E. Albers, Tarek Elfiky, Moritz C. Deml, Helena Milavec, Sebastian F. Bigdon and Lorin M. Benneker
J. Funct. Biomater. 2018, 9(1), 23; https://doi.org/10.3390/jfb9010023 - 14 Mar 2018
Cited by 27 | Viewed by 9580
Abstract
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a [...] Read more.
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a new Ca/PEEK composite cage between 2012 and 2016 were retrospectively identified by an electronic patient chart review. Fusion rates (using X-ray), patient’s satisfaction, and complications were followed up for two years. A total of 90.4% of the patients were pain-free and satisfied after a follow up (FU) period of 29.1 ± 9 (range 24–39) months. A mean increase of 3° in segmental lordosis in the early period (p = 0.002) returned to preoperative levels at final follow-ups. According to the Bridwell classification, the mean 24-month G1 fusion rate was calculated as 93.6% and the G2 as 6.4%. No radiolucency around the cage (G3) or clear pseudarthrosis could be seen (G4). In conclusion, biological properties of the inert, hydrophobic surface, which is the main disadvantage of PEEK, can be improved with VPS titanium coating, so that the carbon/PEEK composite cage, which has great advantages in respect of biomechanical properties, can be used safely in TLIF surgery. High fusion rates, good clinical outcome, and low implant-related complication rates without the need to use rhBMP or additional iliac bone graft can be achieved. Full article
(This article belongs to the Special Issue Biomaterials for Spinal Applications)
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