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

在英国，背痛是导致残疾的主要原因；以椎间盘退变为主要病因。目前的手术选择长期效果不佳，新兴的治疗方法，如在椎间盘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测试不包括患者之间的差异，这对结果有很大的影响。该项目将建立在一个大型研究项目的基础上，旨在开发一种结合实验和计算测试过程的方法，该方法可以独特地包括退变椎间盘的患者变异性。具体目标将是：(1)基于来自尸体组织的3D标本特异性成像和实验数据，开发和验证天然和治疗椎间盘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，以捕捉退变椎间盘和治疗的凝胶样性质。(2)基于三维图像分析的群体模型的发展；(3)识别关键的患者特异性特征，从而能够回答诸如应向椎间盘注射多少生物材料以恢复功能等临床问题。

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.