Local drug delivery challenges and innovations in spinal neurosurgery

The development of novel therapeutics in the field of spinal neurosurgery faces a litany of translational challenges. Achieving precise drug targeting within the confined spaces associated with the spinal cord, canal and vertebra requires the development of next generation delivery systems and devic...

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Bibliographic Details
Published in:Journal of controlled release 2024-12, Vol.376, p.1225-1250
Main Authors: Karavasili, Christina, Young, Thomas, Francis, Joshua, Blanco, Julianna, Mancini, Nicholas, Chang, Charmaine, Bernstock, Joshua D., Connolly, Ian D., Shankar, Ganesh M., Traverso, Giovanni
Format: Article
Language:English
Subjects:
Animals
biocompatible materials
biopharmaceuticals
Drug delivery
Drug Delivery Systems - methods
Drug therapy
Humans
Innovation
landscapes
nanotechnology
Neurosurgery
Neurosurgical Procedures - methods
pain
spinal cord
Spinal Diseases - drug therapy
Spinal Diseases - surgery
Spinal neurosurgery
Spine
Spine - surgery
therapeutics
vertebrae
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Summary:The development of novel therapeutics in the field of spinal neurosurgery faces a litany of translational challenges. Achieving precise drug targeting within the confined spaces associated with the spinal cord, canal and vertebra requires the development of next generation delivery systems and devices. These must be capable of overcoming inherent barriers related to drug diffusion, whilst concurrently ensuring optimal drug distribution and retention. In this review, we provide an overview of the most recent advances in the therapeutic management of diseases and disorders affecting the spine, including systems and devices capable of releasing small molecules and biopharmaceuticals that help eliminate pain and restore the mechanical function and stability of the spine. We highlight material-based approaches and minimally invasive techniques that can be employed to provide control over drug release kinetics and improve retention. We also seek to explore how the newest advancements in nanotechnology, biomaterials, additive manufacturing technologies and imaging modalities can be employed in this translational pursuit. Finally, we discuss the landscape of clinical trials and recently approved products aimed at overcoming the complexities associated with drug delivery to the spine. [Display omitted]
ISSN:0168-3659
1873-4995
1873-4995
DOI:10.1016/j.jconrel.2024.10.055