Anestesia, chirurgia e metodo di raccolta per la valutazione delle viti transpedicolari utilizzando un<em> In Vivo</em> Modello della colonna vertebrale della deriva
Summary
Qui introduciamo un metodo per valutare le viti transpediciche utilizzando un modello di colonna vertebrale lombare in vivo .
Abstract
La fissazione a vite a pedicella è il gold standard per il trattamento delle malattie spinali. Tuttavia, molti studi hanno riportato la questione dell'allentamento delle viti di peduncolo dopo la chirurgia spinale, che è una preoccupazione grave. Per risolvere questo problema, sono stati esaminati diversi tipi di viti di peduncolo per identificare quelli con buona forza di fissazione e osseointegrazione nell'osso della colonna vertebrale. La colonna vertebrale è una buona alternativa per la colonna vertebrale umana nella valutazione delle viti peduncolari a causa della dimensione anatomica, delle caratteristiche meccaniche e dei costi. Sebbene diversi studi abbiano riportato che le viti di peduncolo sono efficaci nel modello della suina, nessuno studio ha descritto protocolli dettagliati per la valutazione di una vite a peduncolo usando il modello porcino. Qui descriviamo un metodo dettagliato per valutare le viti transpedicolari usando un modello di colonna vertebrale lombare in vivo . I dettagli tecnici per l'anestesia, la chirurgia della colonna vertebrale e il raccolto forniti qui faciliteranno con la valutazione del tModello di fissaggio a vite ranspedrici.
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
La valutazione delle viti transpedicolari nella colonna vertebrale richiede molto tempo e fatica. In primo luogo, il maiale in miniatura è un grande animale. Per la cura degli animali e l'anestesia, il ricercatore necessita di un protocollo specializzato. In secondo luogo, la chirurgia dovrebbe mantenere un ambiente simile a quello della chirurgia umana. Lo scopo di valutare le viti di peduncolo nella colonna vertebrale è quello di sviluppare una vite efficiente applicabile agli esseri umani. In terzo luogo, la va…
Disclosures
The authors have nothing to disclose.
Acknowledgements
Questo studio è stato sostenuto da una sovvenzione (CNUH-BRI-2012-02-005) finanziata dall'Istituto di Ricerca Biomedica dell'ospedale universitario di Chonbuk (CNUH-BRI), Repubblica di Corea.
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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