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The intervertebral disc is composed of a complex tissue that separates neighboring vertebrae, permits a wide range of motion, and cushions the high biomechanical forces on the spine. Disc degeneration leads to a loss of function and is often associated with excruciating pain.
Written by leading scientists and clinicians, this is the only book in the past fifty years devoted entirely to the study of the intervertebral disc. The first part of the book provides a review of the basic biology of the disc in health and disease. The second part considers strategies for mitigating the effects of disc degeneration and discusses the possibility of engineering replacement tissues. The final section is dedicated to approaches that model normal development, and the elucidation of the pathogenesis of degenerative disc disease using animal, organ and cell culture techniques.
This unique and authoritative book bridges the gap between the basic and clinical sciences; its target audience includes basic scientists, orthopedists, neurologists, rehabilitation and physical therapists, primary care physicians and chiropractors, while it also addresses the needs of graduate students, medical students, interns, fellows, and patients who suffer from disc-related pathologies.
I. Basic Biology of the Intervertebral Disc.- Overview of the anatomy and physiology of the spinal unit; innervation and vascular status of the disc tissues.- Proteoglycans of the nucleus pulposus, annulus fibrosus and cartilage endplate.- Collagens and other matrix proteins of the nucleus pulposus, annulus fibrosus and cartilage endplate.- Development of the intervertebral disc.- Regulation of disc cell function by oxygen tension.- Osmo- and pH regulation of disc cells.- Effects of growth factors and cytokines on disc cell activity and function.- Microenvironmental regulation of extracellular matrix synthesis by disc cells.- Regulation of tissue mineralization in the disc.- Effects of mechanical forces on disc cell function.- II. Intervertebral Disc Disease.- Epidemiology of degenerative disc disease.- Genetic basis of degenerative disc disease.- Pathogenesis of the degenerative process.- Back pain and disc degeneration.- Imaging modalities for studying the disc pathology.- Current surgical treatments for treating degenerative disc disease.- Total disc replacement.- Non-surgical treatment of degenerative disc disease / back pain.- III. Repair and Regeneration of the Intervertebral Disc.- Use of large animal models to study disc disease.- Small animal models of disc disease.- Use of knockout and transgenic mouse models in disc research.- Organ culture model for studies of the intervertebral disc.- Use of stem cells to regenerate the disc.- Gene therapy approaches for disc regeneration.- Enhancing disc repair by ultrasound, growth factors and other devices.- Hydrogels and other biomaterials to repair the degenerate disc.- Repair of the annulus fibrosus.- Current issues facing successful tissue engineering of the disc
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