麻酔、手術および収縮法を用いた経肛門用ねじの評価<em>インビボ</em>豚の腰椎モデル
Summary
ここでは、 インビボでのブタの腰椎モデルを用いて経椎骨のネジを評価する方法を紹介する。
Abstract
椎弓根スクリュー固定は、脊髄疾患の処置のためのゴールドスタンダードです。しかし、脊髄手術後の茎ねじ緩みの問題が多くの研究によって報告されており、これは深刻な問題である。この問題に対処するために、様々なタイプの椎弓根スクリューを検査し、脊椎骨における良好な固定強度および骨結合を有するものを同定した。ブタの脊椎は、解剖学的サイズ、機械的特性、およびコストのために椎弓根スクリューの評価における人間の背骨のための良い選択肢です。いくつかの研究では、椎弓根スクリューはブタモデルにおいて効率的であると報告されているが、ブタモデルを用いた椎弓根スクリューの評価のための詳細なプロトコールは記載されていない。ここでは、インビボブタ腰椎モデルを使用して経椎骨ねじを評価するための詳細な方法を説明する。ここで提供される麻酔、背骨手術、収穫の技術的な詳細は、ranspedicularスクリュー固定モデル。
Introduction
Transpedicular screw fixation is a gold-standard treatment for degenerative lumbar spine and bursting fracture because it involves three columns of the spine and achieves stabilization1,2. However, most patients who undergo such surgery also have osteoporosis3,4. Many studies have evaluated the fixation strength and the osseointegration status of transpedicular screws, because the loosening of pedicle screws currently in use has been reported in patients with osteoporosis5,6.
The porcine spine is similar to the human spine in terms of size. It is less expensive compared to a primate model7. Furthermore, an in vivo mechanical study has demonstrated that the quadruped porcine spine is essentially loaded in the same way as that of the human spine8, which is why many researchers use porcine spines for studies on the prevention of pedicle screw loosening. However, it takes several months to study pedicle screws in the porcine spine because identifying the long-term stability of pedicle screws takes times. In order to compare different types of screws in the vertebral body, it is necessary to insert the screws in similar positions. Therefore, researchers should be well-acquainted with proper anesthesia techniques, standardized surgical protocols, and harvest procedures before performing any experiments. Here, we describe a detailed method for anesthesia, surgery, and harvest for the evaluation of pedicle screw fixation using a porcine spine model, including ex vivo imaging, histology, and strength testing.
Protocol
Representative Results
Discussion
ブタ背骨における経直腸スクリューの評価は、多くの時間と労力を必要とする。まず、ミニブタは大きな動物です。動物のケアと麻酔については、研究者は特別なプロトコルが必要です。第二に、手術は人間の手術と同様の環境を維持すべきである。ブタ背骨の椎弓根スクリューを評価する目的は、ヒトに適用できる効率的なスクリューを開発することです。第3に、経直腸ねじの長期安定性…
Divulgations
The authors have nothing to disclose.
Acknowledgements
この研究は、韓国の全北大学病院生物医学研究所（CNUH-BRI）の資金提供による助成金（CNUH-BRI-2012-02-005）によって支持された。
Materials
| Miniature pig | OrientBio | ||
| Atropine | Jeil pharmaceutical | A04900241 | Anesthesia |
| Over-the needle plastic catheter | BD | REF382412 | Maintenance of IV line |
| Ketamine | Yuhan | A04502441 | Anesthesia |
| Xylazine | Bayer Korea | A00800071 | Anesthesia |
| Laryngoscope | Karl storz | Intubation | |
| Endotracheal tube | Covidien | Intubation | |
| Isoflurane | JW pharmaceutical Co | A02104781 | Anesthesia |
| Eye ointment | Hanlim pharma | A37851721 | Protection of pig's eye |
| Cefazolin | Donga pharma | A01503951 | Antibiotics |
| Saline | JW pharmaceutical Co | A02151392 | Maintenance of fluid homeostasis |
| Fentanyl | Hana pharm | C03200032 | Pain control |
| Enrofloxacin | Bayer | 93106-60-6 | Antibiotics |
| Morphine | Myungmoon pharma | C03700091 | Pain control |
| Meloxicam | Boehringer Ingelheim | A07600711 | Antibiotics |
| Povidone-iodine | Hyundai pharma | Wound dressing | |
| Scalpel blade size 15 | Braun | I1 BB515 | Skin incision |
| Cobb elevator | Codman | 65-2546 | Dissection of muscle |
| Burr | Medtronic | Making of starting point of screw | |
| Rongeur | Aesculap | FO515R | Making of starting point of screw |
| Guide pin (K-wire) | CE | 01067803 | Guidance of screw trajectory |
| C-arm | GE | OEC 9800 plus | Guidance of screw trajectory |
| Portable X-ray | Siemens | Mobile XP hybrid | Guidance of screw trajectory |
| Pedicle probe | OtisBiotech | SPI-02-01 | Guidance of screw trajectory |
| Pedicle sounding device | OtisBiotech | SPI-03-01 | Guidance of screw trajectory |
| Pedicle screw | OtisBiotech | MS-40025 | |
| Posterior fixator systems | OtisBiotech | ||
| Rod | OtisBiotech | ROD-60140 | Rigid fixation between screws |
| Universal handle | OtisBiotech | SPI-08-01 | To fix the screws to the rod |
| Straight socket wrench | OtisBiotech | SPI-06-01 | To fix the screws to the rod |
| counter torque wrench | OtisBiotech | SPI-07-01 | To fix the screws to the rod |
| Bulb irrigation syringe | Hyupsug medical | HS-IR-140 | Irrigation |
| Silicone drain | Sewon medical | 2205-006 | To drain the fluid at the surgical site |
| 3.0 metric absorbable suture | Ethicon | BA1673H | Muscle suture |
| 2.0 metric nonabsorbable nylon suture | Ethicon | W1626T | Skin suture |
| Gauze | Kingphar Korea | KP120-06 | |
| Pentobarbital | Hanlim pharma | 645301221 | Euthanasia |
| Oscillating saw | Zimmer | Harvest spine | |
| Tower forceps | Aesculap | BF461R | Harvest spine |
References
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