Abstract

Disc herniation is one of the most ubiquitous healthcare problems in modern cities—severe patients eventually require surgical intervention. However, the existing operations—spinal fusion and artificial disc replacement—alter the biomechanics of the spine, leaving much room for improvement. The appropriateness of polyvinyl alcohol (PVA) for biomedical applications has been recognised due to its high water content, excellent biocompatibility, and versatile mechanical properties. In this study, a newly-designed PVA–bacterial cellulose (PVA-BC) composite was assembled to mimic both the biomechanics and annular structure of natural intervertebral discs (IVDs). PVA-BC composites of various concentrations were fabricated and tested under unconfined compression and compressive creep in order to acquire the values of the normalised compressive stiffness and whole normalised deformation. The normalised compressive stiffness increased considerably with an increasing PVA concentration, spanning from 1.82 (±0.18) to 3.50 (±0.14) MPa, and the whole normalised deformation decreased from 0.25 to 0.13. Formulations of 40% PVA provided the most accurate mimicry of natural human IVDs in normalised whole deformation, and demonstrated higher dimensional stability. The biocompatible results further confirmed that the materials had excellent biocompatibility. The novel bionic structure and formulations of the PVA-BC materials mimicked the biomechanics and structure of natural IVDs, and ensured dimensional stability under prolonged compression, reducing the risk of impingement on the surrounding tissue. The PVA-BC composite is a promising material for third-generation artificial IVDs with integrated construction.

Highlights

  • Disc herniation is one of the most common health problems troubling millions of people in modern cities

  • This study introduces a novel polyvinyl alcohol (PVA)-BC composite for third-generation artificial intervertebral discs (IVDs), mimicking the structures and biomechanics of annulus fibrosus (AF) and nucleus pulposus (NP), anatomically and functionally

  • The unconfined compression confirmed that the PVA–bacterial cellulose (PVA-BC) composite has similar nonlinear elasticity and hysteresis to natural IVDs

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Summary

Introduction

Disc herniation is one of the most common health problems troubling millions of people in modern cities. Complications of adjacent segment diseases and loss of motion have urged an alternative treatment of TDR that preserves the motion of the treated segment and decompresses using a dynamic device [3,4,5] Popular devices such as CHARITÉ (DePuy Spine, Inc., Raynham, MA, USA), Prodisc (Synthes, Inc., West Chester, PA, USA), and Activ (Aesculap Implant Systems, LLC, Center Valley, PA, USA) are artificial disc prostheses that replace natural IVDs with the structure of an articulating ball-andsocket joint. They introduce the inevitable problems of friction and wear [6,7]. In most clinical studies, the outcomes of TDR were not superior to fusion [8,9,10,11,12]

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