ArticleSpine2018
Annulus Fibrosus Repair Using High-Density Collagen Gel: An In Vivo Ovine Model.
Article in Spine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- The Functional Role of Interface Tissue Engineering in Annulus Fibrosus Repair: Bridging Mechanisms of Hydrogel Integration with Regenerative Outcomes.ACS biomaterials science & engineering · 2020Pooled it
- What a pain in the back: etiology, diagnosis and future treatment directions for discogenic low back pain.Bone research · 2025Review
- Bioactive Therapies for Degenerative Disc Disease: Challenges and Innovations.World neurosurgery · 2025Article
- Preparation and characterization of 3D hydroxyapatite/collagen scaffolds and its application in bone regeneration with bone morphogenetic protein-2.RSC advances · 2023Article
- Review
- Chemonucleolysis combined with dynamic loading for inducing degeneration in bovine caudal intervertebral discs.Frontiers in bioengineering and biotechnology · 2023Article
- Decoding the annulus fibrosus cell atlas by scRNA-seq to develop an inducible composite hydrogel: A novel strategy for disc reconstruction.Bioactive materials · 2022Article
- Article
- Review
- Effect of Hydroxyapatite Microspheres, Amoxicillin-Hydroxyapatite and Collagen-Hydroxyapatite Composites on Human Dental Pulp-Derived Mesenchymal Stem Cells.Materials (Basel, Switzerland) · 2021Article
- Open-source image analysis software yields reproducible MRI measures of lumbar intervertebral disc degeneration in sheep models.Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association · 2021Article
- Putting the Pieces in Place: Mobilizing Cellular Players to Improve Annulus Fibrosus Repair.Tissue engineering. Part B, Reviews · 2021Review
- Architecture-Promoted Biomechanical Performance-Tuning of Tissue-Engineered Constructs for Biological Intervertebral Disc Replacement.Materials (Basel, Switzerland) · 2021Article
- Imaging the local biochemical content of native and injured intervertebral disc using Fourier transform infrared microscopy.JOR spine · 2020Article
- Mechanical and biological characterization of a composite annulus fibrosus repair strategy in an endplate delamination model.JOR spine · 2020Article
- Application of molybdenum target X-ray photography in imaging analysis of caudal intervertebral disc degeneration in rats.World journal of clinical cases · 2020Article
- Biomimetic angle-ply multi-lamellar scaffold for annulus fibrosus tissue engineering.Journal of materials science. Materials in medicine · 2020Article
- PreclinicalFrontiers in bioengineering and biotechnology · 2020Article
- Core-Shell-Shell Nanoparticles for NIR Fluorescence Imaging and NRET Swelling Reporting of Injectable or Implantable Gels.Biomacromolecules · 2019Article
- Multi-laminate annulus fibrosus repair scaffold with an interlamellar matrix enhances impact resistance, prevents herniation and assists in restoring spinal kinematics.Journal of the mechanical behavior of biomedical materials · 2019Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
STUDY
designOvine in vivo study.
objectiveTo perform lateral approach lumbar surgery in an ovine model to administer an injectable riboflavin cross-linked high-density collagen (HDC) gel and to assess its ability to mitigate intervertebral disc (IVD) degeneration after induced annulus fibrosus (AF) injury. SUMMARY OF BACKGROUND DATA: Biological-based injectable gels have shown efficacy in restoring biomechanical, radiographic, and histological parameters in IVD-injured animal models. Riboflavin cross-linked HDC gel has previously demonstrated retention of nucleus pulposus (NP) tissue, reduced loss of disc height, and prevention of terminal cellular degenerative changes in rat-tail spines. However, this biological therapy has never been tested in large animal models.
methodsForty lumbar IVDs were accessed from eight sheep via lateral approach surgery. IVDs were randomly assigned to healthy control, injury and HDC treatment, or negative control with injury and no treatment. IVD injury was carried out using a drill-bit through the AF followed by needle puncture of the NP. Sheep were followed for 16 weeks and underwent qualitative/quantitative magnetic resonance imaging, x-ray, and histological analyses of collagen and proteoglycan content.
resultsThe lateral approach to the ovine lumbar spine to deliver HDC gel proved to be safe and reproducible. IVDs treated with the HDC gel revealed less degenerative changes at the microscopic level based on AF and NP histology. However, mean Pfirrmann grade, T2 relaxation time, NP voxel size, and disc height index were not significantly different between the two injury groups.
conclusionInjectable HDC gel can be administered safely via lateral approach surgery in an ovine AF injury model. IVDs treated with HDC gel demonstrated less degeneration at the microscopic level though radiographic changes were slight when comparing treated to untreated IVDs. Future studies will need to elucidate the role of injury technique and time frame for follow-up in correlating histological and radiographical outcomes. LEVEL OF EVIDENCE: N /A.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.