Projectleider: Prof Wouter J.A. Dhert, PhD
                        University Medical Center Utrecht
Budget:          € 9.000.000

Do not remove…

The spinal column has a heavy task. It protects our spinal cord and its nerves, carries our body weight, supports the head and absorbs the shocks resulting from physical exercise. No wonder that lower back pain is a very common problem. Two out of three Dutch people will be confronted with this problem during their lifetime. Some people have chronic lower back pain. An important cause of chronic back pain is wear and tear of the intervertebral disc, the soft disc between the vertebrae that together form the spinal column. This degeneration of the intervertebral disc develops due to a previously incurred hernia or gradual wear and tear. Current treatments for lower back pain require the replacement of afflicted vertebrae with bone from elsewhere in the body, or replacement by intervertebral disc prostheses. In both cases, the entire intervertebral disc is removed and only the symptoms are suppressed. These operations also carry risks, such as further damage to the adjacent intervertebral disc, and persistent pain at the sites where the bone was removed.
© BMM / Rogier Trompert Medical Art

… but repair

The purpose of this study is to determine how the function of the degenerated intervertebral disc can be repaired instead of removed. If the degeneration of a vertebral disc is not far advanced, a treatment could consist of injectable, biodegradable materials that release drugs over a longer period of time, thereby stimulating the self-recovery of the intervertebral disc. The materials for the incorporation and release of these compounds may be watery gels, very small spheres (microparticles) or a combination of these two. Next to this, methods are being developed to repair the outside of the intervertebral disc to ensure the injected materials will not diffuse out of the disc. These methods are based on a biodegradable plaster.
A unique aspect of this project is the investigation into the ethical aspects of these new self-repair methods and the moral guidelines for implementing these techniques in patients.


The following companies and institutes work together to make a success of IDiDAS:


  • van Dijk B, Potier E, Ito K. Culturing bovine nucleus pulposus explants by balancing medium osmolarity. Tissue Eng Part C Methods. 2011 Nov;17(11):1089-96. Abstract 
  • Bergknut N, Auriemma E, Wijsman S, Voorhout G, Hagman R, Lagerstedt AS, Hazewinkel HA, Meij BP. Evaluation of intervertebral disk degeneration in chondrodystrophic and nonchondrodystrophic dogs by use of Pfirrmann grading of images obtained with low-field magnetic resonance imaging. Am J Vet Res. 2011 Jul;72(7):893-8. Abstract  
  • Smolders LA, Bergknut N, Kingma I, van der Veen AJ, Smit TH, Koole LH, Hazewinkel HA, Meij BP. Biomechanical evaluation of a novel nucleus pulposus prosthesis in canine cadaveric spines. Vet J. 2011 Jul 2. [Epub ahead of print]  
  • Bergknut N, Rutges JP, Kranenburg HJ, Smolders LA, Hagman R, Smidt HJ, Lagerstedt AS, Voorhout G, Hazewinkel HH, Grinwis GC, Creemers LB, Meij BP, Dhert WJ. The dog as an animal model for intervertebral disc degeneration? Spine (Phila Pa 1976). 2011 May 3 
  • Schroeder Y, Huyghe JM, van Donkelaar CC, Ito K. A biochemical/biophysical 3D FE intervertebral disc model. Biomech Model Mechanobiol. 2010 Oct;9(5):641-50. Abstract  
  • Bergknut N, Smolders LA, Koole LH, Voorhout G, Hagman RE, Lagerstedt AS, Saralidze K, Hazewinkel HA, van der Veen AJ, Meij BP. The performance of a hydrogel nucleus pulposus prosthesis in an ex vivo canine model. Biomaterials. 2010 Sep;31(26):6782-8. Abstract  


  • Niemansburg, SL. The ethics of bringing Regenerative Medicine to patients: the example of orthopedics. PhD Thesis, Utrecht University, Utrecht, Netherlands, 2015.  
  • Dijk, BGM van. A physiological in vitro model of intervertebral disc tissue. PhD Thesis, Eindhoven University of Technology, Eindhoven, Netherlands, 2013. 
  • Smolders, L. New treatment strategies for canine intervertebral disc degeneration. PhD Thesis, Utrecht University, Utrecht, Netherlands, 2013.
  • Sharifi S. The development of novel biodegradable polymeric biomaterials for use in the repair of damaged intervertebral discs. PhD Thesis, University of Groningen, Groningen, Netherlands, 2012.
  • Kranenburg HJ. Spine Research in Companion Animals. PhD thesis, Utrecht University, Utrecht, Netherlands, 2012.
  • Bergknut N. Intervertebral Disk Degeneration in Dogs. Doctoral Thesis Swedish University of Agricultural Sciences & Utrecht University, Uppsala & Utrecht, 2011.  


Last updated on 2015-04-12