General Abstract

The developing fields of bone tissue engineering and regenerative medicine have identified skeletal defects, such as degenerative disorders of the lumbar spine, as attractive translational targets. Bone tissue engineering comprises cells, biomaterials, which should preferably be biodegradable, and biologics (biological stimuli to trigger differentiation of stem cells). Mesenchymal stem cells (MSCs) for tissue engineering can be isolated from bone marrow, which is only available in limited amounts. Adipose tissue provides an abundant source of MSCs, which is easily accessible by resection or liposuction. After lineage-specific stimulation, adipose tissue-derived MSCs (AT-MSCs) can differentiate along the osteogenic, chondrogenic, neuronal, myogenic, and adipogenic pathways. In addition, AT-MSCs exhibit an in vivo osteogenic potential, comparable to that of bone marrow-derived MSCs, and almost comparable to that of osteoblasts. AT-MSCs provide a very promising source of stem cells for the regeneration of functional bone tissue as desired for bone tissue engineering. A bone tissue engineering approach could be envisaged for spinal interbody fusion surgeries performed in patients with various degenerative spinal disorders, in which non-surgical treatments fail. This thesis is describing the functionality of AT-MSCs for bone tissue engineering and proposes a novel concept of a one-step surgical procedure for spinal interbody fusion. The following questions are adressed.