Enabling stratification of intervertebral disc repair with a combined experimental and computational approach

在英国，背部疼痛是导致多年来残疾的主要原因；椎间盘退行性变是主要的病因诊断。目前的手术方案长期效果不佳，新兴的治疗方法，如在椎间盘内注射生物材料以减轻退变的影响，到目前为止还未能成功地转化为临床实践。这主要是因为临床前试验不包括患者之间的变异性，这对结果有很大影响。该项目将建立在一个大型研究计划的基础上，目的是开发一种综合的实验和计算测试过程，其中可以独特地包括患者退变的椎间盘的变异性。具体目标将是(1)基于身体组织的3D标本特定成像和实验数据，开发和验证用于天然和经处理的椎间盘的机械性能的稳健计算模型。这些计算模型将包括多孔和/或粘性效应，以捕捉退变的椎间盘和治疗方法的凝胶状本质。(2)基于3D图像分析的人群模型的发展；以及(3)关键的患者特定特征的识别，这些特征能够回答临床问题，例如应该向椎间盘中注入多少生物材料来恢复功能。

Back pain is the leading cause of years lived with disability in the UK; with disc degeneration the main causal diagnosis. Current surgical options have poor long-term outcomes and emerging treatments, such as injection of biomaterials in the intervertebral disc to alleviate effects of degeneration, have so far failed to be successfully translated to clinical practice. This is mostly because preclinical testing does not include variability from patient to patient, which has a large effect on the outcome. This project will build on a large programme of research with the aim to develop a combined experimental and computational testing process, which can uniquely include patient variability of degenerated intervertebral discs. Specific objectives will be (1) the development and validation of robust computational models for the mechanical performance of natural and treated intervertebral discs based on 3D specimen-specific imaging and experimental data from cadaver tissue. These computational models will include porous and/or viscous effects to capture the gel-like nature of the degenerated intervertebral disc and of treatments. (2) The development of population models based on 3D image analysis, and (3) identification of key patient-specific characteristics that enable answering clinical questions such as how much biomaterial should be injected into the intervertebral disc to restore function.