Morgan B Giers1, Bryce T Munter2, Kyle J Eyster2, George D Ide1, Anna G U S Newcomb3, Jennifer N Lehrman1, Evgenii Belykh4, Vadim A Byvaltsev5, Brian P Kelly1, Mark C Preul1, Nicholas Theodore6. 1. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. 2. School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA. 3. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA; School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA. 4. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA; Department of Neurosurgery, Irkutsk Scientific Center of Surgery and Traumatology, Irkutsk, Russia; Department of Neurosurgery, Irkutsk State University, Irkutsk, Russia. 5. Department of Neurosurgery, Irkutsk Scientific Center of Surgery and Traumatology, Irkutsk, Russia. 6. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: Neuropub@dignityhealth.org.
Abstract
BACKGROUND: Physical data are lacking on nutrient transport in human intervertebral discs (IVDs), which support regeneration. Our objective was to study nutrient transport in porcine IVDs to determine the effects of biomechanical and physiological factors. METHODS: In vitro testing of whole porcine IVDs was performed under different loading conditions. Fifty cervical, thoracic, and lumbar discs with attached end plates were removed from 4 Yorkshire pigs (90-150 lbs). Discs were placed in Safranin O or Fast Green FCF histological stains in diffusion or diurnal compression-tested groups. The end plate was studied by the use of polyurethane to block it. Traction was studied with a mechanical testing frame. Discs were cut transversely and photographed. Images were analyzed for depth of annulus fibrosus (AF) stained. The nucleus pulposus (NP) was assigned a staining score. RESULTS: Results showed no difference in AF staining between the 2 stains (P = 0.60). The depth of AF staining did not increase (P = 0.60) due to convection or disc height change via diurnal loading. The NP in all open end plate samples was stained completely by day 3. NP staining was decreased in blocked end plate samples (P = 0.07) and AF staining was significantly less in traction samples than in diffusion-only samples (P = 0.04). CONCLUSIONS: This method showed that most small molecule nutrient transport occurs via the end plate. Compressive load was a negligible benefit or hindrance to transport. Traction hindered transport in the short term. This method can be used to study strategies for increasing nutrient transport in IVDs.
BACKGROUND: Physical data are lacking on nutrient transport in human intervertebral discs (IVDs), which support regeneration. Our objective was to study nutrient transport in porcine IVDs to determine the effects of biomechanical and physiological factors. METHODS: In vitro testing of whole porcine IVDs was performed under different loading conditions. Fifty cervical, thoracic, and lumbar discs with attached end plates were removed from 4 Yorkshire pigs (90-150 lbs). Discs were placed in Safranin O or Fast Green FCF histological stains in diffusion or diurnal compression-tested groups. The end plate was studied by the use of polyurethane to block it. Traction was studied with a mechanical testing frame. Discs were cut transversely and photographed. Images were analyzed for depth of annulus fibrosus (AF) stained. The nucleus pulposus (NP) was assigned a staining score. RESULTS: Results showed no difference in AF staining between the 2 stains (P = 0.60). The depth of AF staining did not increase (P = 0.60) due to convection or disc height change via diurnal loading. The NP in all open end plate samples was stained completely by day 3. NP staining was decreased in blocked end plate samples (P = 0.07) and AF staining was significantly less in traction samples than in diffusion-only samples (P = 0.04). CONCLUSIONS: This method showed that most small molecule nutrient transport occurs via the end plate. Compressive load was a negligible benefit or hindrance to transport. Traction hindered transport in the short term. This method can be used to study strategies for increasing nutrient transport in IVDs.