The Human Vertebral Endplate: biomechanical study in spinal disorders
Research type
Research Study
Full title
THE HUMAN VERTEBRAL ENDPLATE: A BIOMECHANICAL, PERFUSION, AND HISTOLOGICAL STUDY OF ITS INVOLVEMENT IN SPINAL DISORDERS CAUSING BACK PAIN.
IRAS ID
174756
Contact name
David Sharp
Contact email
Sponsor organisation
The Ipswich Hospital NHS Trust
Duration of Study in the UK
2 years, 8 months, 1 days
Research summary
Biomechanical Study of the Human Vertebral End-Plate: Summary.
1. The Problem.
The vertebrae of the spine are linked together by the Inter-Vertebral Disc (IVD), which is "sandwiched" between the bony End-Plate (E-P). The IVD is a vital part of the normal mechanical function of the spine. Nutrition of the normal IVD is dependent on diffusion of nutrients from arteries within the E-P.
Many cases of Low Back Pain are associated with Degenerative Disc Disease (DDD).
In those cases with intractable pain, surgery (spinal fusion) is the mainstay of treatment, but remains controversial.Therefore, over the past decade, biological systems (notably intra-discal gene therapy and stem cells) to alter the natural history of DDD have been developed, which will be dependent on the Degenerating Disc being viable.
At the same time, there has been a revolution in the development of biomaterials which can replicate the biomechanical function of the disc (abnormal loading of the EP is a pain generator, and biomaterials may have a better chance of relieving pain if they can match the mechanical properties of the EP).
Whilst there is detailed understanding of the degenerating disc, there is very limited understanding of the pathology of the vertebral bone, upon which the use of these new materials will depend.
2. Aims of the study.
The principle aim of this study is to investigate the EP, the findings being correlated with clinical classification of spinal pathology:
(i) Trephine specimens will be taken from the vertebra of patients undergoing surgery (without altering current surgical practice).
(ii) The structure of the EP will be investigated with nano-hardness, micro-CT scanning, non-linear microscopy, and perfusiont techniques at The Department of Materials at Cambridge and Physics at Exeter Universities.3. Summary.
This multi-centre, multi-disciplinary project will significantly further our understanding of spinal pathology and the management of this difficult group of patients.REC name
East of England - Cambridge South Research Ethics Committee
REC reference
16/EE/0103
Date of REC Opinion
4 May 2016
REC opinion
Further Information Favourable Opinion