Evidence map›Paper›PMID 40180662›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Optimized hydrogel viscoelasticity and interlocking patch repair enhance compressive range of motion in injured discs and prevent re-herniation under physiological load in an Ex Vivo model.

Danilo Menghini, Esteban Ongini, Jan Devan, Pamela Bitterli, Matteo D'Este, Oliver Distler, Mazda Farshad, Sibylle Grad, Jess Snedeker, Stefan Dudli

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Danilo MenghiniInstitute for Biomechanics, ETH Zürich, Zürich, Zürich, Switzerland.ORCID 0009-0000-7677-9602
Esteban OnginiDepartment of Orthopedics, Balgrist University Hospital, University of Zürich, Zürich, Zürich, Switzerland.ORCID 0009-0005-9091-4483
Jan DevanCenter of Experimental Rheumatology, Department of Rheumatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.ORCID 0009-0009-1544-7511
Pamela BitterliCenter of Experimental Rheumatology, Department of Rheumatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.ORCID 0009-0005-3897-7807
Matteo D'EsteAO Research Institute Davos, Davos Platz, Switzerland.ORCID 0000-0002-0424-8172
Oliver DistlerCenter of Experimental Rheumatology, Department of Rheumatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.ORCID 0000-0002-0546-8310
Mazda FarshadDepartment of Orthopedics, Balgrist University Hospital, University of Zürich, Zürich, Zürich, Switzerland.ORCID 0000-0002-7190-1127
Sibylle GradInstitute for Biomechanics, ETH Zürich, Zürich, Zürich, Switzerland.ORCID 0000-0001-9552-3653
Jess SnedekerInstitute for Biomechanics, ETH Zürich, Zürich, Zürich, Switzerland.ORCID 0000-0002-8115-0275
Stefan DudliCenter of Experimental Rheumatology, Department of Rheumatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland. stefan.dudli@usz.ch.ORCID 0000-0001-7351-713X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEvaluate how variations in hydrogels viscoelasticity for nucleus pulposus (NP) replacement affect biomechanical function and re-herniation resistance when combined with a mechanically competent annulus fibrosus (AF) repair technique in an intervertebral disc explant model.

methodsBovine caudal discs (n = 48) were divided into three repair groups (each n = 12) and one no-repair group (n = 12). Repair groups were treated with hyaluronic acid-tyramine hydrogel (HA-Tyr) of varying viscosities (low, medium, high), and AF was repaired using a mechanically interlocked patch (iPatch) made of polyethylene terephthalate fibers. Disc biomechanics were assessed under rotational and compressive-tensile cycles for each specimen (A) in intact state, (B) after experimental herniation/discectomy, and (C) after treatment. Afterwards, load capacity until NP herniation or hydrogel extrusion was determined.

resultsDiscectomy significantly altered axial and torsional parameters compared to intact discs. Combined iPatch/hydrogel treatment improved axial parameters by reducing range of motion (ROM), neutral zone length, and restoring compressive stiffness, whereas tensile stiffness remained unaffected. Significant differences in ROM were found between unrepaired discs and medium or high viscoelasticity hydrogels. Torsional parameters improved likewise. Low viscoelasticity hydrogel showed the highest load resistance (8.5 MPa) and lowest herniation probability. Under physiological load, only medium viscoelasticity hydrogels did not herniate.

conclusionHigher viscoelastic hydrogels enhance compressive ROM and axial compressive stiffness after discectomy but increase herniation risk. Medium viscoelastic hydrogels resist physiological loads without herniating while still enhancing ROM. This study highlights the need to optimize NP replacement and suggests a combination that opens promising therapeutic avenues for future applications.

Indexed as

HydrogelsIntervertebral DiscIntervertebral Disc DisplacementRange of Motion, ArticularAnimalsAnnulus FibrosusBiomechanical PhenomenaCattleDiskectomyElasticityHyaluronic AcidViscosityHyaluronic AcidHydrogelsAnnulus fibrosus repairHerniation resistanceHyaluronic acid-tyramine hydrogelHydrogel viscoelasticityIntervertebral disc biomechanicsNucleus pulposus replacement

Identifiers

PMID40180662

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Registered trials

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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.