Une méthode d'anesthésie, de chirurgie et de récolte pour l'évaluation des vis transpediculaires en utilisant un<em> In vivo</em> Modèle de la colonne lombaire porcine
Summary
Ici, nous introduisons une méthode pour évaluer les vis transpediculaires en utilisant un modèle de colonne lombaire porcine in vivo .
Abstract
La fixation par vis pédiculaire est l'étalon-or pour le traitement des maladies de la colonne vertébrale. Cependant, de nombreuses études ont rapporté la question du desserrage des vis pédiculaires après une chirurgie de la colonne vertébrale, ce qui est une préoccupation sérieuse. Pour résoudre ce problème, divers types de vis pédiculaires ont été examinés pour identifier ceux qui ont une bonne résistance à la fixation et une ostéointégration dans l'os de la colonne vertébrale. La colonne vertébrale porcine est une bonne alternative pour la colonne vertébrale humaine dans l'évaluation des vis pédiculaires en raison de la taille anatomique, des caractéristiques mécaniques et des coûts. Bien que plusieurs études aient indiqué que les vis pédiculaires sont efficaces dans le modèle porc, aucune étude n'a décrit les protocoles détaillés pour l'évaluation d'une vis pédiculaire à l'aide du modèle porcin. Ici, nous décrivons une méthode détaillée pour évaluer les vis transpediculaires en utilisant un modèle de colonne lombaire porcine in vivo . Les détails techniques pour l'anesthésie, la chirurgie de la colonne vertébrale et les récoltes fournies ici faciliteront l'évaluation de la tModèle de fixation à vis ranspedic.
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
L'évaluation des vis transpediculaires dans la colonne vertébrale nécessite beaucoup de temps et d'effort. Tout d'abord, le cochon miniature est un gros animal. Pour les soins aux animaux et l'anesthésie, le chercheur a besoin d'un protocole spécialisé. Deuxièmement, la chirurgie devrait maintenir un environnement similaire à celui de la chirurgie humaine. Le but de l'évaluation des vis du pédicule dans la colonne vertébrale du porc est de développer une vis efficace qui peut être ap…
Disclosures
The authors have nothing to disclose.
Acknowledgements
Cette étude a été soutenue par une subvention (CNUH-BRI-2012-02-005) financée par l'Institut de recherche biomédicale de l'hôpital universitaire national de Chonbuk (CNUH-BRI), République de Corée.
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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