Repair, regenerative and supportive therapies of the annulus fibrosus: achievements and challenges

Eur Spine J. 2009 Mar;18(3):301-13. doi: 10.1007/s00586-008-0856-x. Epub 2008 Dec 23.


Lumbar discectomy is a very effective therapy for neurological decompression in patients suffering from sciatica due to hernia nuclei pulposus. However, high recurrence rates and persisting post-operative low back pain in these patients require serious attention. In the past decade, tissue engineering strategies have been developed mainly targeted to the regeneration of the nucleus pulposus (NP) of the intervertebral disc. Accompanying techniques that deal with the damaged annulus fibrous are now increasingly recognised as mandatory in order to prevent re-herniation to increase the potential of NP repair and to confine NP replacement therapies. In the current review, the requirements, achievements and challenges in this quickly emerging field of research are discussed.

Publication types

  • Review

MeSH terms

  • Animals
  • Diskectomy / methods
  • Fibrocartilage / pathology
  • Fibrocartilage / physiopathology
  • Fibrocartilage / surgery
  • Guided Tissue Regeneration / methods*
  • Guided Tissue Regeneration / trends
  • Humans
  • Intervertebral Disc / pathology
  • Intervertebral Disc / physiopathology
  • Intervertebral Disc / surgery*
  • Intervertebral Disc Displacement / pathology
  • Intervertebral Disc Displacement / physiopathology
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / physiopathology
  • Lumbar Vertebrae / surgery*
  • Pain, Postoperative / etiology
  • Pain, Postoperative / physiopathology
  • Pain, Postoperative / prevention & control
  • Secondary Prevention
  • Tissue Engineering / methods*
  • Tissue Engineering / trends