Failure forces of different interspinous vertebropexy techniques.

Background Context: Challenges of vertebropexy such as spinous process fractures and tendon pull-out under high flexion loads need to be further investigated to ensure long-term stability of the construct.

Purpose: Vertebropexy is a technique using a tendon as a posterior tension band to stabilize vertebral segments. Failure modes include pull-out or spinous process fractures under high flexion loads.

Tendon response to matrix unloading is determined by the patho-physiological niche.

Although the molecular mechanisms behind tendon disease remain obscure, aberrant stromal matrix turnover and tissue hypervascularity are known hallmarks of advanced tendinopathy. We harness a tendon explant model to unwind complex cross-talk between the stromal and vascular tissue compartments. We identify the hypervascular tendon niche as a state-switch that gates degenerative matrix remodeling within the tissue stroma.