Finite Element Study of Nutrient Diffusion in the Human Intervertebral Disc

Study Design. The diffusion of small nutrients in the intervertebral human disc was examined using a finite element model. Objective. To investigate nutrient transport into the disc using a numerical approach. Summary of Background Data. The intervertebral disc is the largest avascular tissue in the body. Nutrients necessary for cellular survival diffuse from the blood supply around the disc margins to the cells. Limited analytical studies have been performed and compared with measurements. However, the studies have only considered supply through the center of the nucleus and have only examined single solutes. A more sophisticated model is required to investigate the solute supply. Materials and Methods. An axisymmetric finite element model has been created to study the transport of three solutes, i.e., oxygen, glucose, and lactate, using nonlinear consumption–concentration and production–concentration rates. For each of them, data for the consumption/production rate, diffusivity, and concentration in the blood were taken from experimental measurements and used in the model. The effect of varying disc height, exchange area with the blood supply, solute consumption rates, and diffusivities was investigated. Results. The model predicted that concentrations of oxygen and glucose, which are consumed by cells, fell towards the disc center. Concentration levels decreased with a decrease in fractional exchange area and diffusivity, or with an increase in disc height and consumption rate. In contrast, the concentration of lactate, produced by the cells, was highest in the center and fell towards the disc–blood vessel interface. The absolute values of concentrations were in agreement with available measurements in vivo and those computed by few available analytical models, indicating the reliability of the finite element simulations. Conclusions. Finite element methods can be used to predict concentration gradients of solutes throughout the disc in relation to changes in disc and endplate morphology, disc properties, and cellular activities. This study provides a foundation for investigating the effect of load-induced changes or effects of changes in cellular metabolism on disc nutritional supply.

[1]  S. Bibby,et al.  Intervertebral Disc Composition in Neuromuscular Scoliosis: Changes in Cell Density and Glycosaminoglycan Concentration at the Curve Apex , 2001, Spine.

[2]  C. Peter Winlove,et al.  Oxygen and Lactate Concentrations Measured in Vivo in the Intervertebral Discs of Patients With Scoliosis and Back Pain , 1998, Spine.

[3]  A. Maroudas,et al.  Influence of cyclic loading on the nutrition of articular cartilage. , 1990, Annals of the rheumatic diseases.

[4]  A. Penttilä,et al.  Lumbar Disc Degeneration and Atherosclerosis of the Abdominal Aorta , 1994, Spine.

[5]  J P Urban,et al.  The Effect of Lactate and pH on Proteoglycan and Protein Synthesis Rates in the Intervertebral Disc , 1992, Spine.

[6]  K. Ito,et al.  Direction-dependent constriction flow in a poroelastic solid: the intervertebral disc valve. , 2000, Journal of biomechanical engineering.

[7]  A. Nachemson,et al.  In vitro diffusion of dye through the end-plates and the annulus fibrosus of human lumbar inter-vertebral discs. , 1970, Acta orthopaedica Scandinavica.

[8]  A. Maroudas,et al.  Diffusion of small solutes into the intervertebral disc: as in vivo study. , 1978, Biorheology.

[9]  A. Maroudas,et al.  Biophysical chemistry of cartilaginous tissues with special reference to solute and fluid transport. , 1975, Biorheology.

[10]  R. Stockwell The interrelationship of cell density and cartilage thickness in mammalian articular cartilage. , 1971, Journal of anatomy.

[11]  S Holm,et al.  Nutrition of the intervertebral disc: solute transport and metabolism. , 1981, Connective tissue research.

[12]  Stockwell Ra The interrelationship of cell density and cartilage thickness in mammalian articular cartilage. , 1971 .

[13]  H. V. Crock,et al.  Anatomic Studies of the Circulation in the Region of the Vertebral End-Plate in Adult Greyhound Dogs , 1984, Spine.

[14]  S Holm,et al.  Nutrition of the intervertebral disk. An in vivo study of solute transport. , 1977, Clinical orthopaedics and related research.

[15]  A. Ejeskär,et al.  Oxygen tension measurements in the intervertebral disc. A methodological and experimental study. , 1979, Upsala journal of medical sciences.

[16]  A R Hargens,et al.  Intervertebral disc nutrition. Diffusion versus convection. , 1986, Clinical orthopaedics and related research.

[17]  A. Nachemson,et al.  Factors involved in the nutrition of the human lumbar intervertebral disc: cellularity and diffusion of glucose in vitro. , 1975, Journal of anatomy.

[18]  S. Roberts,et al.  Proteoglycan synthesis in the intervertebral disk nucleus: the role of extracellular osmolality. , 1997, The American journal of physiology.

[19]  A. Nachemson,et al.  Correlation between lactate levels and pH in discs of patients with lumbar rhizopathies , 1968, Experientia.

[20]  S. Holm,et al.  Factors Influencing Oxygen Concentration Gradients in the Intervertebral Disc: A Theoretical Analysis , 1991, Spine.

[21]  T. Keller,et al.  1990 Volvo Award in Experimental Studies: The Dependence of Intervertebral Disc Mechanical Properties on Physiologic Conditions , 1990, Spine.

[22]  Tony S. Keller,et al.  1990 Volvo Award in experimental studies. The dependence of intervertebral disc mechanical properties on physiologic conditions. , 1990 .

[23]  S Holm,et al.  Nutrition of the intervertebral disc: effect of fluid flow on solute transport. , 1982, Clinical orthopaedics and related research.

[24]  C. Evans,et al.  Nitric oxide and energy production in articular chondrocytes , 1994, Journal of cellular physiology.

[25]  S. Roberts,et al.  Transport Properties of the Human Cartilage Endplate in Relation to Its Composition and Calcification , 1996, Spine.

[26]  C. P. Winlove,et al.  Electrochemical method for direct measurement of oxygen concentration and diffusivity in the intervertebral disc: electrochemical characterization and tissue-sensor interactions. , 1991, Journal of biomedical engineering.

[27]  A Shirazi-Adl,et al.  On the fibre composite material models of disc annulus--comparison of predicted stresses. , 1989, Journal of biomechanics.

[28]  J. Taylor,et al.  Growth of human intervertebral discs and vertebral bodies. , 1975, Journal of anatomy.

[29]  J. Urban,et al.  Effects of low oxygen concentrations and metabolic inhibitors on proteoglycan and protein synthesis rates in the intervertebral disc , 1999, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[30]  H. Horner,et al.  2001 Volvo Award Winner in Basic Science Studies: Effect of Nutrient Supply on the Viability of Cells From the Nucleus Pulposus of the Intervertebral Disc , 2001, Spine.