Tissue-engineered approaches for the treatment of early-stage intervertebral disc degeneration have shown promise in preclinical studies. However, none of these therapies has been approved for clinical use, in part because each therapy targets only one aspect of the intervertebral disc’s composite structure. At present, there is no reliable method to prevent intervertebral disc degeneration after herniation and subsequent discectomy. Here, we demonstrate the prevention of degeneration and maintenance of mechanical function in the ovine lumbar spine after discectomy by combining strategies for nucleus pulposus augmentation using hyaluronic acid injection and repair of the annulus fibrosus using a photocrosslinked collagen patch. This combined approach healed annulus fibrosus defects, restored nucleus pulposus hydration, and maintained native torsional and compressive stiffness up to 6 weeks after injury. These data demonstrate the necessity of a combined strategy for arresting intervertebral disc degeneration and support further translation of combinatorial interventions to treat herniations in the human spine.

组织工程治疗早期椎间盘退变的方法在临床前研究中显示出了希望。但是，这些疗法均未获批准用于临床，部分原因是每种疗法仅针对椎间盘复合结构的一个方面。目前，尚没有可靠的方法来防止椎间盘突出症和椎间盘切除术后的椎间盘退变。在这里，我们通过结合使用透明质酸注射增强髓核和使用光致交联胶原蛋白膜修复纤维环的方法，证明了椎间盘切除术后绵羊腰椎变性和机械功能的维持。这种组合方法可以治愈纤维环的缺陷，恢复髓核的水合作用，并在受伤后长达6周保持天然的扭转和压缩刚度。这些数据表明，必须采取综合策略来制止椎间盘退变，并支持进一步翻译组合疗法以治疗人的脊柱突出症。