Nisolle Jean Francois, Neveu Fabienne, Hontoir Fanny, Clegg Peter, Kirschvink Nathalie, Vandeweerd Jean-Michel
Centre Hospitalier Universitaire Mont Godinne, Université Catholique de Louvain, Yvoir, Belgium.
Eur Spine J. 2013 Dec;22(12):2760-5. doi: 10.1007/s00586-013-2936-9. Epub 2013 Aug 11.
Disc injection to create intervertebral (IVD) disc degeneration (IVDD) has been reported in ovine models, but the techniques have not been thoroughly described. The current ex vivo study aimed to evaluate a computed tomography (CT)-guided injection technique into IVDs in the ovine lumbar spine.
Insertion of needles into the nucleus pulposus was assessed by gross anatomic dissection in two lumbar segments (group A), and injection of liquid within the disc was assessed by discography in six segments (group B).
The pathway of the needle was simulated on computer after an initial CT scan, followed by control of the insertion process via a laser beam and monitoring scans. In group A, 20 insertions were assessed and 17 needles (85 %) were successfully positioned in the nucleus pulposus. In group B of 30 injections, the rate of success was 90 %.
The current study provides useful clinical information that will help surgeons working with an ovine model for research on IVDD. This model could also be useful to train less experienced surgeons or radiologists to disc injection. This CT-guided injection seems to offer several advantages such as ease of use, good success rate and safety to important nervous and vascular structures.
在绵羊模型中已报道通过椎间盘注射来诱发椎间盘退变(IVDD),但相关技术尚未得到充分描述。当前的离体研究旨在评估一种在绵羊腰椎间盘内进行计算机断层扫描(CT)引导注射的技术。
通过大体解剖对两个腰段(A组)的髓核穿刺针插入情况进行评估,通过椎间盘造影对六个节段(B组)的椎间盘内液体注射情况进行评估。
在初始CT扫描后,在计算机上模拟针的路径,随后通过激光束控制插入过程并进行监测扫描。在A组中,评估了20次穿刺,17根针(85%)成功定位在髓核内。在B组的30次注射中,成功率为90%。
本研究提供了有用的临床信息,将有助于使用绵羊模型进行IVDD研究的外科医生。该模型对于培训经验较少的外科医生或放射科医生进行椎间盘注射也可能有用。这种CT引导注射似乎具有几个优点,如使用方便、成功率高以及对重要神经和血管结构安全。