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经皮后外侧入路模拟绵羊模型中的极外侧椎间盘突出症

Percutaneous posterolateral approach for the simulation of a far-lateral disc herniation in an ovine model.

作者信息

Schwan Stefan, Ludtka Christopher, Wiesner Ingo, Baerthel Andre, Friedmann Andrea, Göhre Felix

机构信息

Translational Centre of Regenerative Medicine TRM, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.

Department of Biological and Macromolecular Materials, Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Walter-Hülse-Str. 1, 06120, Halle (Saale), Germany.

出版信息

Eur Spine J. 2018 Jan;27(1):222-230. doi: 10.1007/s00586-017-5362-6. Epub 2017 Oct 27.

Abstract

PURPOSE

This work describes a minimally invasive damage model for ovine lumbar discs via partial nucleotomy using a posterolateral approach.

METHODS

Two cadavers were dissected to analyze the percutaneous corridor. Subsequently, 28 ovine had their annulus fibrosus punctured via awl penetration under fluoroscopic control and nucleus pulposus tissue removed via rongeur. Efficacy was assessed by animal morbidity, ease of access to T12-S1 disc spaces, and production of a mechanical injury as verified by discography, radiography, and histology.

RESULTS

T12-S1 were accessible with minimal nerve damage morbidity. Scar tissue sealed the disc puncture site in all animals within 6 weeks, withstanding 1 MP of intradiscal pressure. Partial nucleotomy led to a significant reduction in intervertebral disk height and an increased histological degeneration score.

CONCLUSION

Inducing a reproducible injury pattern of disc degeneration required minimal time, effort, and equipment. The posterolateral approach allows operation on several discs within a single surgery and multiple animal surgeries within a single day.

摘要

目的

本研究描述了一种通过后外侧入路进行部分髓核切除术建立羊腰椎间盘微创损伤模型的方法。

方法

解剖两具尸体以分析经皮通道。随后,在透视控制下,用锥子穿刺28只羊的纤维环,并使用咬骨钳去除髓核组织。通过动物发病率、进入T12-S1椎间盘间隙的难易程度以及经椎间盘造影、放射摄影和组织学证实的机械损伤情况来评估疗效。

结果

T12-S1椎间盘间隙易于进入,神经损伤发病率极低。在6周内,所有动物的椎间盘穿刺部位均被瘢痕组织封闭,可承受1兆帕的椎间盘内压力。部分髓核切除术导致椎间盘高度显著降低,组织学退变评分增加。

结论

诱导可重复的椎间盘退变损伤模式所需时间、精力和设备最少。后外侧入路允许在一次手术中对多个椎间盘进行操作,并且在一天内可进行多只动物的手术。

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