Journal
REGENERATIVE BIOMATERIALS
Volume 7, Issue 2, Pages 181-193Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rb/rbz044
Keywords
mineralized collagen; lumbar degenerative disc disease; percutaneous cement discoplasty; fibrous encapsulation
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Funding
- National Natural Science Foundation of China [81971755]
- Sichuan Science and Technology Innovation Team of China [2019JDTD0008]
- Young Elite Scientist Sponsorship Program by CAST [2019QNRC001]
- Fundamental Research Funds for the Central Universities, 111 Project of China [B16033]
- Key Research and Development Project of Heibei Province [182777172]
- Provincial Key Technology Support Program of Sichuan [2015SZ0027]
- Graduate Student's Research and Innovation Fund of Sichuan University [2018YJSY067]
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As a minimally invasive surgery, percutaneous cement discoplasty (PCD) is now contemplated to treat lumbar disc degeneration disease in elder population. Here, we investigated whether the osteogenic mineralized collagen (MC) modified polymethylmethacrylate (PMMA) cement could be a suitable material in PCD surgery. Injectability, hydrophilicity and mechanical properties of the MC-modified PMMA (PMMA-MC) was characterized. The introduction of MC did not change the application and setting time of PMMA and was easy to be handled in minimally invasive operation. Hydrophilicity of PMMA-MC was greatly improved and its elastic modulus was tailored to complement mechanical performance of bone under dynamic stress. Then, PCD surgery in a goat model with induced disc degeneration was performed with implantation of PMMA-MC or PMMA. Three months after implantation, micro-computed tomography analysis revealed a 36.4% higher circumferential contact index between PMMA-MC and bone, as compared to PMMA alone. Histological staining confirmed that the surface of PMMA-MC was in direct contact with new bone, while the PMMA was covered by fibrous tissue. The observed gathering of macrophages around the implant was suspected to be the cause of fibrous encapsulation. Therefore, the interactions of PMMA and PMMA-MC with macrophages were investigated in vitro. We discovered that the addition of MC could hinder the proliferation and fusion of the macrophages. Moreover, expressions of fibroblast-stimulating growth factors, insulin-like growth factor, basic fibroblast growth factor and tumor necrosis factor-beta were significantly down-regulated in the macrophages cocultured with PMMA-MC. Together, the promoted osteointegration and reduced fibrous tissue formation observed with PMMA-MC material makes it a promising candidate for PCD surgery.
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