A Biodegradable Glue for Annulus Closure: Evaluation of Strength and Endurance

P.P.A. Vergroesen, Agnieszka Bochynska, K.S. Emanuel, Shahriar Sharifi, I. Kingma, Dirk W. Grijpma, T.H. Smit

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Scopus)

Abstract

Study Design: A biodegradable glue was biomechanically tested for annulus closure using nondegenerated goat intervertebral discs. Ultimate strength and endurance tests were performed using native and punctured discs as positive and negative controls, respectively. Objective: The aim of this study was to investigate the feasibility and biomechanical properties of a biodegradable glue for annulus closure. Summary of Background Data: There is an unmet clinical need for annulus closure techniques. Isocyanate-terminated tissue glues show potential because they adhere to annulus tissue, have an elastic modulus similar to the annulus, and show limited cytotoxicity to human annulus fibrosus cells. Methods: Three biomechanical tests were performed divided in 2 parts: part 1: ultimate strength tests comparing native, punctured (2.4-mm needle), and glued caprine intervertebral discs (n = 11 per group); part 2: 10 discs per group were subjected to a 10-day ex vivo endurance test of 864,000 load cycles, followed by ultimate strength tests. Outcome parameters include the restoration of strength after puncture, reduction of herniation in the endurance test, and conservation of glue strength after endurance testing. Results: Part 1: The glue partially restored subsidence to failure and yield strength/ultimate strength ratio of intervertebral discs. Part 2: During endurance testing, 40% of punctured discs failed compared with none of the glued discs. Endurance testing did not affect glue strength, and pooling of ultimate strength tests showed that the glue restored ultimate strength, work to failure, and yield strength/ultimate strength to 79%, 75%, and 119% of native values, respectively. Conclusion: A biodegradable isocyanate-terminated glue increases the force at which nucleus protrusion occurs, and it limits herniations during endurance or ultimate strength tests. Biomechanical tests in a bioreactor provide a low-cost assessment for annulus repair strategies; however, the clinical efficacy needs to be further addressed using long-term in vivo studies.
Original languageUndefined
Pages (from-to)622-628
JournalSpine
Volume40
Issue number9
DOIs
Publication statusPublished - 2015

Keywords

  • METIS-315300
  • IR-99655

Cite this

Vergroesen, P. P. A., Bochynska, A., Emanuel, K. S., Sharifi, S., Kingma, I., Grijpma, D. W., & Smit, T. H. (2015). A Biodegradable Glue for Annulus Closure: Evaluation of Strength and Endurance. Spine, 40(9), 622-628. https://doi.org/10.1097/BRS.0000000000000792
Vergroesen, P.P.A. ; Bochynska, Agnieszka ; Emanuel, K.S. ; Sharifi, Shahriar ; Kingma, I. ; Grijpma, Dirk W. ; Smit, T.H. / A Biodegradable Glue for Annulus Closure: Evaluation of Strength and Endurance. In: Spine. 2015 ; Vol. 40, No. 9. pp. 622-628.
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title = "A Biodegradable Glue for Annulus Closure: Evaluation of Strength and Endurance",
abstract = "Study Design: A biodegradable glue was biomechanically tested for annulus closure using nondegenerated goat intervertebral discs. Ultimate strength and endurance tests were performed using native and punctured discs as positive and negative controls, respectively. Objective: The aim of this study was to investigate the feasibility and biomechanical properties of a biodegradable glue for annulus closure. Summary of Background Data: There is an unmet clinical need for annulus closure techniques. Isocyanate-terminated tissue glues show potential because they adhere to annulus tissue, have an elastic modulus similar to the annulus, and show limited cytotoxicity to human annulus fibrosus cells. Methods: Three biomechanical tests were performed divided in 2 parts: part 1: ultimate strength tests comparing native, punctured (2.4-mm needle), and glued caprine intervertebral discs (n = 11 per group); part 2: 10 discs per group were subjected to a 10-day ex vivo endurance test of 864,000 load cycles, followed by ultimate strength tests. Outcome parameters include the restoration of strength after puncture, reduction of herniation in the endurance test, and conservation of glue strength after endurance testing. Results: Part 1: The glue partially restored subsidence to failure and yield strength/ultimate strength ratio of intervertebral discs. Part 2: During endurance testing, 40{\%} of punctured discs failed compared with none of the glued discs. Endurance testing did not affect glue strength, and pooling of ultimate strength tests showed that the glue restored ultimate strength, work to failure, and yield strength/ultimate strength to 79{\%}, 75{\%}, and 119{\%} of native values, respectively. Conclusion: A biodegradable isocyanate-terminated glue increases the force at which nucleus protrusion occurs, and it limits herniations during endurance or ultimate strength tests. Biomechanical tests in a bioreactor provide a low-cost assessment for annulus repair strategies; however, the clinical efficacy needs to be further addressed using long-term in vivo studies.",
keywords = "METIS-315300, IR-99655",
author = "P.P.A. Vergroesen and Agnieszka Bochynska and K.S. Emanuel and Shahriar Sharifi and I. Kingma and Grijpma, {Dirk W.} and T.H. Smit",
year = "2015",
doi = "10.1097/BRS.0000000000000792",
language = "Undefined",
volume = "40",
pages = "622--628",
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Vergroesen, PPA, Bochynska, A, Emanuel, KS, Sharifi, S, Kingma, I, Grijpma, DW & Smit, TH 2015, 'A Biodegradable Glue for Annulus Closure: Evaluation of Strength and Endurance' Spine, vol. 40, no. 9, pp. 622-628. https://doi.org/10.1097/BRS.0000000000000792

A Biodegradable Glue for Annulus Closure: Evaluation of Strength and Endurance. / Vergroesen, P.P.A.; Bochynska, Agnieszka; Emanuel, K.S.; Sharifi, Shahriar; Kingma, I.; Grijpma, Dirk W.; Smit, T.H.

In: Spine, Vol. 40, No. 9, 2015, p. 622-628.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - A Biodegradable Glue for Annulus Closure: Evaluation of Strength and Endurance

AU - Vergroesen, P.P.A.

AU - Bochynska, Agnieszka

AU - Emanuel, K.S.

AU - Sharifi, Shahriar

AU - Kingma, I.

AU - Grijpma, Dirk W.

AU - Smit, T.H.

PY - 2015

Y1 - 2015

N2 - Study Design: A biodegradable glue was biomechanically tested for annulus closure using nondegenerated goat intervertebral discs. Ultimate strength and endurance tests were performed using native and punctured discs as positive and negative controls, respectively. Objective: The aim of this study was to investigate the feasibility and biomechanical properties of a biodegradable glue for annulus closure. Summary of Background Data: There is an unmet clinical need for annulus closure techniques. Isocyanate-terminated tissue glues show potential because they adhere to annulus tissue, have an elastic modulus similar to the annulus, and show limited cytotoxicity to human annulus fibrosus cells. Methods: Three biomechanical tests were performed divided in 2 parts: part 1: ultimate strength tests comparing native, punctured (2.4-mm needle), and glued caprine intervertebral discs (n = 11 per group); part 2: 10 discs per group were subjected to a 10-day ex vivo endurance test of 864,000 load cycles, followed by ultimate strength tests. Outcome parameters include the restoration of strength after puncture, reduction of herniation in the endurance test, and conservation of glue strength after endurance testing. Results: Part 1: The glue partially restored subsidence to failure and yield strength/ultimate strength ratio of intervertebral discs. Part 2: During endurance testing, 40% of punctured discs failed compared with none of the glued discs. Endurance testing did not affect glue strength, and pooling of ultimate strength tests showed that the glue restored ultimate strength, work to failure, and yield strength/ultimate strength to 79%, 75%, and 119% of native values, respectively. Conclusion: A biodegradable isocyanate-terminated glue increases the force at which nucleus protrusion occurs, and it limits herniations during endurance or ultimate strength tests. Biomechanical tests in a bioreactor provide a low-cost assessment for annulus repair strategies; however, the clinical efficacy needs to be further addressed using long-term in vivo studies.

AB - Study Design: A biodegradable glue was biomechanically tested for annulus closure using nondegenerated goat intervertebral discs. Ultimate strength and endurance tests were performed using native and punctured discs as positive and negative controls, respectively. Objective: The aim of this study was to investigate the feasibility and biomechanical properties of a biodegradable glue for annulus closure. Summary of Background Data: There is an unmet clinical need for annulus closure techniques. Isocyanate-terminated tissue glues show potential because they adhere to annulus tissue, have an elastic modulus similar to the annulus, and show limited cytotoxicity to human annulus fibrosus cells. Methods: Three biomechanical tests were performed divided in 2 parts: part 1: ultimate strength tests comparing native, punctured (2.4-mm needle), and glued caprine intervertebral discs (n = 11 per group); part 2: 10 discs per group were subjected to a 10-day ex vivo endurance test of 864,000 load cycles, followed by ultimate strength tests. Outcome parameters include the restoration of strength after puncture, reduction of herniation in the endurance test, and conservation of glue strength after endurance testing. Results: Part 1: The glue partially restored subsidence to failure and yield strength/ultimate strength ratio of intervertebral discs. Part 2: During endurance testing, 40% of punctured discs failed compared with none of the glued discs. Endurance testing did not affect glue strength, and pooling of ultimate strength tests showed that the glue restored ultimate strength, work to failure, and yield strength/ultimate strength to 79%, 75%, and 119% of native values, respectively. Conclusion: A biodegradable isocyanate-terminated glue increases the force at which nucleus protrusion occurs, and it limits herniations during endurance or ultimate strength tests. Biomechanical tests in a bioreactor provide a low-cost assessment for annulus repair strategies; however, the clinical efficacy needs to be further addressed using long-term in vivo studies.

KW - METIS-315300

KW - IR-99655

U2 - 10.1097/BRS.0000000000000792

DO - 10.1097/BRS.0000000000000792

M3 - Article

VL - 40

SP - 622

EP - 628

JO - Spine

JF - Spine

SN - 0362-2436

IS - 9

ER -