• Sarah E Gullbrand, Joshua Peterson, Jenna Ahlborn, Rosemarie Mastropolo, Arun Fricker, Timothy T Roberts, Mostafa Abousayed, James P Lawrence, Joseph C Glennon, and Eric H Ledet.
• *Department of Biomedical Engineering, Rensselear Polytechnic Institute, Troy, NY †Division of Orthopaedic Surgery, Albany Medical College, Albany, NY; and ‡Veterinary Specialties, Pattersonville, NY.
• Spine. 2015 Aug 1; 40 (15): 1158-64.

Study DesignExperimental animal study of convective transport in the intervertebral disc.ObjectiveTo quantify the effects of mechanical loading rate on net transport into the healthy and degenerative intervertebral disc in vivo.Summary Of Background DataIntervertebral disc degeneration is linked with a reduction in transport to the avascular disc. Enhancing disc nutrition is, therefore, a potential strategy to slow or reverse the degenerative cascade. Convection induced by mechanical loading is a potential mechanism to augment diffusion of small molecules into the disc.MethodsSkeletally mature New Zealand white rabbits with healthy discs and discs degenerated via needle puncture were subjected to low rate axial compression and distraction loading for 2.5, 5, 10, 15, or 20 minutes after a bolus administration of gadodiamide. Additional animals with healthy discs were subjected to high-rate loading for 10 minutes or no loading for 10 minutes. Transport into the disc for each loading regimen was quantified using post-contrast-enhanced magnetic resonance imaging.ResultsLow-rate loading resulted in the rapid uptake and clearance of gadodiamide in the disc. Low-rate loading increased net transport into the nucleus by a mean 16.8% and 12.6% in healthy and degenerative discs, respectively. The kinetics of small molecule uptake and clearance were accelerated in both healthy and degenerative discs with low-rate loading. In contrast, high-rate loading reduced transport into nucleus by a mean 16.8%.ConclusionThese results illustrate that trans-endplate diffusion can be enhanced by forced convection in both healthy and degenerative discs in vivo. Mechanical loading-induced convection could offer therapeutic benefit for degenerated discs by enhancing uptake of nutrients and clearance of by-products.Level Of Evidence4.

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