First-time systematic postoperative clinical assessment of a minimally invasive approach for lumbar ventrolateral vertebroplasty in the large animal model sheep

被引：17

作者：

Bungartz, Matthias ^{[1
,2
]}

Maenz, Stefan ^{[3
,4
]}

Kunisch, Elke ^{[2
]}

Horbert, Victoria ^{[2
]}

Xin, Long ^{[2
]}

Gunnella, Francesca ^{[2
]}

Mika, Joerg ^{[2
,8
,9
]}

Borowski, Juliane ^{[2
]}

Bischoff, Sabine ^{[5
]}

Schubert, Harald ^{[5
]}

Sachse, Andre ^{[1
]}

Illerhaus, Bernhard ^{[6
]}

Guenster, Jens ^{[6
]}

Bossert, Joerg ^{[3
]}

Jandt, Klaus D. ^{[3
,4
,7
]}

Kinne, Raimund W. ^{[2
]}

Brinkmann, Olaf ^{[1
,2
]}

机构：

[1] Waldkrankenhaus Rudolf Elle, Jena Univ Hosp, Dept Orthoped, Chair Orthoped, Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany

[2] Waldkrankenhaus Rudolf Elle, Jena Univ Hosp, Dept Orthoped, Expt Rheumatol Unit, Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany

[3] Friedrich Schiller Univ Jena, Otto Schott Inst Mat Res, Chair Mat Sci, Lobdergraben 32, D-07743 Jena, Germany

[4] Friedrich Schiller Univ Jena, JSMC, Neugasse 23, D-07743 Jena, Germany

[5] Jena Univ Hosp, Inst Lab Anim Sci & Welf, Dornburger Str 23, D-07743 Jena, Germany

[6] BAM Bundesanstalt Mat Forsch & Prufung BAM, Unter Eichen 87, D-12205 Berlin, Germany

[7] Friedrich Schiller Univ Jena, JCSM, Humboldstr 10, D-07743 Jena, Germany

[8] Justus Liebig Univ Giessen, Lab Expt Trauma Surg, D-35394 Giessen, Germany

[9] Univ Hosp Giessen Marburg, Dept Trauma Hand & Reconstruct Surg Giessen, Campus Giessen,Rudolf Buchheim Str 7, D-35385 Giessen, Germany

来源：

SPINE JOURNAL | 2016年 / 16卷 / 10期

关键词：

Calcium phosphate cement; Large animal model; Minimal-invasive; Sheep; Ventrolateral; Vertebroplasty; Void defect; CALCIUM-PHOSPHATE CEMENT; VERTEBRAL BODY FRACTURE; BONE HISTOMORPHOMETRY; PERCUTANEOUS VERTEBROPLASTY; CARDIOVASCULAR CHANGES; FAT-EMBOLISM; BIOMECHANICAL EVALUATION; PULMONARY-EMBOLISM; NOMENCLATURE; KYPHOPLASTY;

D O I：

10.1016/j.spinee.2016.06.015

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND CONTEXT: Large animal models are highly recommended for meaningful preclinical studies, including the optimization of cement augmentation for vertebral body defects by vertebroplasty/kyphoplasty. PURPOSE: The aim of this study was to perform a systematic characterization of a strictly minimally invasive in vivo large animal model for lumbar ventrolateral vertebroplasty. STUDY DESIGN/SETTING: This is a prospective experimental animal study. METHODS: Lumbar defects (diameter 5 mm; depth approximately 14 mm) were created by a ventrolateral percutaneous approach in aged, osteopenic, female sheep (40 Merino sheep; 6-9 years; 68-110 kg). L1 remained untouched, L2 was left with an empty defect, and L3 carried a defect injected with a brushite-forming calcium phosphate cement (CPC). Trauma/functional impairment, surgical techniques (including drill sleeve and working canula with stop), reproducibility, bone defects, cement filling, and functional cement augmentation were documented by intraoperative incision-to-suture time and X-ray, postoperative trauma/impairment scores, and ex vivo osteodensitometry, microcomputed tomography (CT), histology, static/fluorescence histomorphometry, and biomechanical testing. RESULTS: Minimally invasive vertebroplasty resulted in short operation times (28 +/- 2 minutes; mean +/- standard error of the mean) and X-ray exposure (1.59 +/- 0.12 minutes), very limited local trauma (score 0.00 +/- 0.00 at 24 hours), short postoperative recovery (2.95 +/- 0.29 hours), and rapid decrease of the postoperative impairment score to 0 (3.28 +/- 0.36 hours). Reproducible defect creation and cement filling were documented by intraoperative X-ray and ex vivo conventional/micro-CT. Vertebral cement augmentation and osteoconductivity of the CPC was verified by osteodensitometry (CPC> control), micro-CT (CPC> control and empty defect), histology/static histomorphometry (CPC> control and empty defect), fluorescence histomorphometry (CPC> control; all p<. 05 for 3 and 9 months), and compressive strength measurements (CPC numerically higher than control; 102% for 3 months and 110% for 9 months). CONCLUSIONS: This first-time systematic clinical assessment of a minimally invasive, ventrolateral, lumbar vertebroplasty model in aged, osteopenic sheep resulted in short operation times, rapid postoperative recovery, and high experimental reproducibility. This model represents an optimal basis for standardized evaluation of future studies on vertebral augmentation with resorbable and osteoconductive CPC. (C) 2016 Elsevier Inc. All rights reserved.

引用

页码：1263 / 1275

页数：13

共 60 条

[1] Polymethylmethacrylate causes prolonged pulmonary hypertension during fat embolism - A study in sheep [J].