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Review
. 2009 Mar;18(3):301-13.
doi: 10.1007/s00586-008-0856-x. Epub 2008 Dec 23.

Repair, regenerative and supportive therapies of the annulus fibrosus: achievements and challenges

Johannes Leendert Bron  1 , Marco N Helder, Hans-Jorg Meisel, Barend J Van Royen, Theodoor H Smit
Affiliations
Review

Repair, regenerative and supportive therapies of the annulus fibrosus: achievements and challenges

Johannes Leendert Bron et al. Eur Spine J. 2009 Mar.

Abstract

Lumbar discectomy is a very effective therapy for neurological decompression in patients suffering from sciatica due to hernia nuclei pulposus. However, high recurrence rates and persisting post-operative low back pain in these patients require serious attention. In the past decade, tissue engineering strategies have been developed mainly targeted to the regeneration of the nucleus pulposus (NP) of the intervertebral disc. Accompanying techniques that deal with the damaged annulus fibrous are now increasingly recognised as mandatory in order to prevent re-herniation to increase the potential of NP repair and to confine NP replacement therapies. In the current review, the requirements, achievements and challenges in this quickly emerging field of research are discussed.

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Figures

Fig. 1
Fig. 1
Histological image (toluidine blue) of the canine intervertebral disc revealing the relation between the nucleus pulposus (NP), annulus fibrosus (AF) and endplates (EP). Some of the most central AF fibres bend with the NP (arrow)
Fig. 2
Fig. 2
Saggital section specimen of the L3–L4 intervertebral disc of a middle aged asymptomatic male subject. NP nucleus pulposus, IA inner annulus fibrosus, OA outer annulus fibrosus. Defects in the outer annulus (asterisk) and tears (hat symbol) are visible in the outer annulus, without a sign of herniation. The NP has a severely dehydrated appearance due to conservation techniques
See this image and copyright information in PMC

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