Transpediküler Vidaların Değerlendirilmesinde Anestezi, Cerrahi ve Hasat Yöntemi<emIn vivo</em> Domuz Kemik Omurgası Modeli
Summary
Burada, in vivo domuz lomber omurga modelini kullanarak transpediküler vidaları değerlendiren bir yöntem sunuyoruz.
Abstract
Pedikül vidası fiksasyonu omurga hastalıklarının tedavisinde altın standarttır. Bununla birlikte, birçok çalışma omurga cerrahisinden sonra pedikül vidalarını gevşetme sorununu bildirmiştir ve bu ciddi bir endişe kaynağıdır. Bu problemi çözmek için, omurga kemiğinde iyi tespit gücü ve osseoentegrasyon gösterenleri belirlemek için çeşitli pedikül vidaları incelendi. Domuz omurgası anatomik boyut, mekanik özellikler ve maliyet nedeniyle pedikül vidalarının değerlendirilmesinde insan omurgası için iyi bir alternatiftir. Birkaç çalışma, pedikül vidalarının domuz modelinde etkin olduğunu bildirmiş olsa da, hiçbir çalışma, domuz modelini kullanan bir pedikül vidasının değerlendirilmesi için ayrıntılı protokolleri tarif etmemiştir. Burada, in vivo domuz lumbar omurga modelini kullanarak transpediküler vidaların değerlendirilmesi için ayrıntılı bir yöntem anlatılmaktadır. Anestezi, omurga ameliyatı ve burada sağlanan hasat için teknik ayrıntılar, tRanspediküler vida fiksasyon modeli.
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
Domuz omurganındaki transpediküler vidaların değerlendirilmesi çok zaman ve emek gerektirir. Birincisi, minyatür domuz büyük bir hayvandır. Hayvan bakımı ve anestezi için, araştırmacının özel bir protokole ihtiyacı vardır. İkincisi, ameliyat insan cerrahisine benzer bir çevreyi korumalıdır. Domuz omurgasındaki pedikül vidalarını değerlendirmenin amacı, insanlara uygulanabilecek etkili bir vida geliştirmektir. Üçüncü olarak, transpediküler vidaların uzun süreli stabilitesinin değerle…
Disclosures
The authors have nothing to disclose.
Acknowledgements
Bu çalışma Chonbuk Ulusal Üniversite Hastanesi Biyomedikal Araştırma Enstitüsü (CNUH-BRI) tarafından finanse edilen bir hibe (CNUH-BRI-2012-02-005) tarafından desteklenmiştir.
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 |
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