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

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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.