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dc.contributor.authorCapogna, Elizabeth Ann
dc.description.abstractOne of the primary diseases responsible for low back pain, which is the leading cause of disability worldwide, is intervertebral disc degeneration. The intervertebral disc is a complex, avascular structure of the spine that is approximately 80% water, has active cells that maintain the disc matrix, and that naturally degenerates with age. The disc cells receive key nutrients and expel waste products via trans-endplate diffusion. Increased metabolic activity of the disc cells in attempt to repair a degenerated matrix, rapidly deplete the nutrient supply resulting in an imbalance between nutrient supply and demand. This imbalance may explain the disc’s poor regenerative potential and propensity for degeneration. For mild to moderate stages of degeneration, developing a method to enhance nutrient transport to the disc could increase the disc’s own regenerative potential and serve as a therapeutic approach for arresting or reversing disc degeneration. Thus, the overarching hypothesis of this work was that chronic low-rate cyclic loading of a degenerated intervertebral disc can augment transport of small molecules and subsequently alter the progression of degeneration by increasing the disc’s own regenerative potential. \ In this work, an animal model was developed to allow for the study of transport kinetics due to low-rate cyclic loading in vivo in both healthy and degenerated intervertebral discs, and the effect of a daily cyclic loading on intervertebral disc health in vivo. Animals with healthy and moderately degenerated intervertebral discs were cyclically loaded just before imaging to determine convective nutrient transport enhancement. Animals with moderately degenerated discs then underwent daily application of low-rate cyclic loading for 8-weeks to determine the effect of sustained nutrient enhancement on the progression of degeneration. For both healthy and moderately degenerated intervertebral discs, there was nutrient transport enhancement due to low rate cyclic loading. Daily application of low-rate cyclic loading of a moderately degenerated intervertebral discs showed regeneration of the disc structure and improvement in overall disc health. This work demonstrates the ability of an intervertebral disc to regenerate and the potential of low-rate cyclic loading to serve as a none-invasive and non-pharmacologic means of treating intervertebral disc degeneration in humans.

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