Percutaneous posterolateral approach for the simulation of a far-lateral disc herniation in an ovine model

Schwan, Stefan; Ludtka, Christopher; Wiesner, Ingo; Baerthel, Andre; Friedmann, Andrea; Göhre, Felix

doi:10.1007/s00586-017-5362-6

Cited by 9 publications

(18 citation statements)

References 32 publications

(49 reference statements)

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“…Oehme et al 15 reported operation times of 60 min per animal, four times longer than our proposed method. In contrast to a previous study using this same methodology, 16 no animals showed any neurological deficits following surgery. However, this may be partially attributable to the JOURNAL OF ORTHOPAEDIC RESEARCH ® NOVEMBER 2019 cumulative experience of the operating surgeon, who also conducted the surgeries in the previous study.…”

Section: Discussioncontrasting

confidence: 99%

“…Prior to the first operation, each animal's overall and spine health was assessed in a general physical examination. During the first surgery, one lumbar IVD per animal was damaged via partial nucleotomy according to the previously described method . Figure A shows the surgical tools used for the operation.…”

Section: Methodsmentioning

confidence: 99%

“…B); then, a rongeur (Fehling Ceramo 1.5 rongeur; Fehling Instruments, Karlstein, Germany) was guided to the NP through the surgical corridor created for NP tissue removal (Fig. C), of approximately 0.15 cm 3 , as described by Schwan et al Both steps were carried out under X‐ray control.…”

Section: Methodsmentioning

confidence: 99%

“…During the first surgery, one lumbar IVD per animal was damaged via partial nucleotomy according to the previously described method. 16 Figure 1A shows the surgical tools used for the operation. The awl (Aesculap FG 268 R-4000 K-Aesculap, Tuttlingen, Germany) has a flattened, elliptical tip (3.0 mm; 1.1 mm) that was used to puncture the annulus fibrosus (AF) ( Fig.…”

Section: Animal Modelmentioning

confidence: 99%

“…However, previous studies on these animals typically involve a damage model using chemical injection into the nucleus pulposus (NP), disc degeneration without annulus fibrosus (AF) damage, or partial nucleotomy requiring a large incision and open surgery . A minimally invasive method for creating a reproduceable IVD injury analogous to a disc herniation has been previously reported and uses a partial nucleotomy via a dorsolateral approach. However, the progressive degeneration resulting from such a method has not been previously reported.…”

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confidence: 99%

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Long‐Term Pathology of Ovine Lumbar Spine Degeneration Following Injury Via Percutaneous Minimally Invasive Partial Nucleotomy

Schwan

Ludtka

Friedmann

et al. 2019

Journal Orthopaedic Research

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The focus of this work is to assess the long‐term progression of degeneration in the ovine lumbar spine following a minimally invasive model injury comparable to the damage of an intervertebral disc (IVD) herniation. A partial nucleotomy was performed on 18 sheep via the percutaneous dorsolateral approach. The animals were culled at 6 and 12 months to evaluate the damaged and neighboring functional spine units (FSUs) for degenerative characteristics via μ‐CT and histology. Both quantitative μ‐CT and histology investigations demonstrated statistically significant differences between the native and damaged FSUs investigated. Qualitative analysis of μ‐CT revealed numerous pathological markers consistent with intervertebral disc degeneration (IDD), with differences in frequency and severity between the native and damaged FSUs. The annulus fibrosus reforms a pressure seal within 6 weeks, but the extent of the trauma is significant enough to initiate IVD degeneration, which is already clearly visible at 6 months and especially so 12 months post‐op. IDD pathology consistent with signs of a herniation was seen in both the 6‐ and 12‐month groups. This technique provides a useful model injury for the preclinical evaluation of IDD in large animal models, especially in regards to simulating disc herniation as well as for testing the efficacy of associated therapies in the future. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2376–2388, 2019

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Section: Discussioncontrasting

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Animal Modelmentioning

confidence: 99%

mentioning

confidence: 99%

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Long‐Term Pathology of Ovine Lumbar Spine Degeneration Following Injury Via Percutaneous Minimally Invasive Partial Nucleotomy

Schwan

Ludtka

Friedmann

et al. 2019

Journal Orthopaedic Research

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An update on animal models of intervertebral disc degeneration and low back pain: Exploring the potential of artificial intelligence to improve research analysis and development of prospective therapeutics

et al. 2023

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Animal models have been invaluable in the identification of molecular events occurring in and contributing to intervertebral disc (IVD) degeneration and important therapeutic targets have been identified. Some outstanding animal models (murine, ovine, chondrodystrophoid canine) have been identified with their own strengths and weaknesses. The llama/alpaca, horse and kangaroo have emerged as new large species for IVD studies, and only time will tell if they will surpass the utility of existing models. The complexity of IVD degeneration poses difficulties in the selection of the most appropriate molecular target of many potential candidates, to focus on in the formulation of strategies to effect disc repair and regeneration. It may well be that many therapeutic objectives should be targeted simultaneously to effect a favorable outcome in human IVD degeneration. Use of animal models in isolation will not allow resolution of this complex issue and a paradigm shift and adoption of new methodologies is required to provide the next step forward in the determination of an effective repairative strategy for the IVD. AI has improved the accuracy and assessment of spinal imaging supporting clinical diagnostics and research efforts to better understand IVD degeneration and its treatment. Implementation of AI in the evaluation of histology data has improved the usefulness of a popular murine IVD model and could also be used in an ovine histopathological grading scheme that has been used to quantify degenerative IVD changes and stem cell mediated regeneration. These models are also attractive candidates for the evaluation of novel anti‐oxidant compounds that counter inflammatory conditions in degenerate IVDs and promote IVD regeneration. Some of these compounds also have pain‐relieving properties. AI has facilitated development of facial recognition pain assessment in animal IVD models offering the possibility of correlating the potential pain alleviating properties of some of these compounds with IVD regeneration.

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Long‐term pre‐clinical evaluation of an injectable chitosan nanocellulose hydrogel with encapsulated adipose‐derived stem cells in an ovine model for IVD regeneration

Schmitt

Radetzki

Stirnweiss

et al. 2021

J Tissue Eng Regen Med

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The potential therapeutic benefit of adipose‐derived stem cells (ASCs) encapsulated in an injectable hydrogel for stimulating intervertebral disc (IVD) regeneration has been assessed by a number of translational and preclinical studies. However, previous work has been primarily limited to small animal models and short‐term outcomes of only a few weeks. Long‐term studies in representative large animal models are crucial for translation into clinical success, especially for permanent stabilization of major defects such as disc herniation. An injectable chitosan carboxymethyl cellulose hydrogel scaffold loaded with ASCs was evaluated regarding its intraoperative handling, crosslinking kinetics, cell viability, fully‐crosslinked viscoelasticity, and long‐term therapeutic effects in an ovine model. Three IVDs per animal were damaged in 10 sheep. Subcutaneous adipose tissue was the source for autologous ASCs. Six weeks after IVD damage, two of the damaged IVDs were treated via ASC‐loaded hydrogel injection. After 12 months following the implantation, IVD disc height and histological and cellular changes were assessed. This system was reliable and easy to handle intraoperatively. Over 12 months, IVD height was stabilized and degeneration progression significantly mitigated compared to untreated, damaged IVDs. Here we show for the first time in a large animal model that an injectable chitosan carboxymethyl cellulose hydrogel system with encapsulated ASCs is able to affect long‐term stabilization of an injured IVD and significantly decrease degeneration processes as compared to controls.

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Percutaneous posterolateral approach for the simulation of a far-lateral disc herniation in an ovine model

Abstract: Inducing a reproducible injury pattern of disc degeneration required minimal time, effort, and equipment. The posterolateral approach allows operation on several discs within a single surgery and multiple animal surgeries within a single day.

Cited by 9 publications

References 32 publications

Long‐Term Pathology of Ovine Lumbar Spine Degeneration Following Injury Via Percutaneous Minimally Invasive Partial Nucleotomy

Long‐Term Pathology of Ovine Lumbar Spine Degeneration Following Injury Via Percutaneous Minimally Invasive Partial Nucleotomy

An update on animal models of intervertebral disc degeneration and low back pain: Exploring the potential of artificial intelligence to improve research analysis and development of prospective therapeutics

Long‐term pre‐clinical evaluation of an injectable chitosan nanocellulose hydrogel with encapsulated adipose‐derived stem cells in an ovine model for IVD regeneration

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