The transpedicular approach for the study of intervertebral disc regeneration strategies: in vivo characterization

PurposeTo characterize in vivo the transpedicular approach (TA) as an alternative route to study intervertebral disc (IVD) regeneration strategies in a sheep model.Methods48 IVD of 12 sheep were used. TA was performed under fluoroscopy, followed by nucleotomy (2-mm shaver resector). A polyurethane scaffold was used to repair the end-plate. X-ray and MRI images were acquired pre-, intra- and post-operatively (1, 3, 6 months). Complications were recorded.ResultsTA was feasible in all animals; nucleus pulposus (NP) from L1 to L5 was accessible. Nucleotomy followed by end-plate repair was achieved. Loss of NP signal intensity was shown in MRI images of the nucleotomy group.ConclusionsTA is feasible in vivo, repeatable after only a short learning period and safely performed without significant morbidity. This animal model allows the study of IVD degeneration physiopathology and investigation of IVD regeneration techniques in vivo.

[1]  Masanori Sasaki,et al.  Effects of Chondroitinase ABC on Intradiscal Pressure in Sheep: An In Vivo Study , 2001, Spine.

[2]  B. Vernon‐roberts,et al.  1990 Volvo Award in experimental studies. Anulus tears and intervertebral disc degeneration. An experimental study using an animal model. , 1990 .

[3]  Vincenzo Denaro,et al.  Intervertebral disc regeneration: from the degenerative cascade to molecular therapy and tissue engineering , 2015, Journal of tissue engineering and regenerative medicine.

[4]  M. Alini,et al.  Thiol-Containing Degradable Poly(thiourethane-urethane)s for Tissue Engineering , 2010, Journal of biomaterials science. Polymer edition.

[5]  L. Claes,et al.  Anatomy of the sheep spine and its comparison to the human spine , 1997, The Anatomical record.

[6]  V. Denaro,et al.  Electrospun scaffolds for bone tissue engineering , 2011, Musculoskeletal surgery.

[7]  Vincenzo Denaro,et al.  Mesenchymal stem cells injection in degenerated intervertebral disc: cell leakage may induce osteophyte formation , 2012, Journal of tissue engineering and regenerative medicine.

[8]  T. Hansson,et al.  Experimental Disc Degeneration Due to Endplate Injury , 2004, Journal of spinal disorders & techniques.

[9]  M. Menger,et al.  In vitro and in vivo evaluation of a novel nanosize hydroxyapatite particles/poly(ester-urethane) composite scaffold for bone tissue engineering. , 2010, Acta biomaterialia.

[10]  J. Ralphs,et al.  Are animal models useful for studying human disc disorders/degeneration? , 2007, European Spine Journal.

[11]  E. Hurwitz,et al.  7. Does Discography Cause Accelerated Progression of Degeneration Changes in the Lumbar Disc: A Ten-Year Cohort-Controlled Study , 2009 .

[12]  T. Steffen,et al.  A surgical approach to the ventral aspect of the lumbar vertebrae in the sheep model , 2000, Surgical and Radiologic Anatomy.

[13]  L. Benneker,et al.  Development of an in vivo experimental model for percutaneous vertebroplasty in sheep , 2012, Veterinary and Comparative Orthopaedics and Traumatology.

[14]  G. Jenkin,et al.  Lateral Surgical Approach to Lumbar Intervertebral Discs in an Ovine Model , 2012, TheScientificWorldJournal.

[15]  G. Giorgi,et al.  Vertebral body recollapse without trauma after kyphoplasty with calcium phosphate cement , 2011, Musculoskeletal surgery.

[16]  Yang Zhang,et al.  Improving fixation strength of pedicle screw by microarc oxidation treatment: An experimental study of osteoporotic spine in sheep , 2012, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[17]  V. Denaro,et al.  Spondylodiscitis: standards of current treatment , 2012, Current medical research and opinion.

[18]  V. Denaro,et al.  Bioactive electrospun scaffold for annulus fibrosus repair and regeneration , 2012, European Spine Journal.

[19]  L. Claes,et al.  Are Sheep Spines a Valid Biomechanical Model for Human Spines? , 1997, Spine.

[20]  O. Osti Annulus tears and intervertebral disc degeneration , 1990 .

[21]  Mauro Alini,et al.  The Transpedicular Approach As an Alternative Route for Intervertebral Disc Regeneration , 2013, Spine.

[22]  E. Hurwitz,et al.  2009 ISSLS Prize Winner: Does Discography Cause Accelerated Progression of Degeneration Changes in the Lumbar Disc: A Ten-Year Matched Cohort Study , 2009, Spine.

[23]  S. Itescu,et al.  Cervical Interbody Fusion Is Enhanced by Allogeneic Mesenchymal Precursor Cells in an Ovine Model , 2011, Spine.

[24]  M. Alini,et al.  Tailoring thermoreversible hyaluronan hydrogels by "click" chemistry and RAFT polymerization for cell and drug therapy. , 2010, Biomacromolecules.

[25]  J. García-Sancho,et al.  Intervertebral Disc Repair by Autologous Mesenchymal Bone Marrow Cells: A Pilot Study , 2011, Transplantation.

[26]  B. Vernon‐roberts,et al.  1990 Volvo Award in Experimental Studies: Anulus Tears and Intervertebral Disc Degeneration: An Experimental Study Using an Animal Model , 1990, Spine.

[27]  D Eglin,et al.  In vivo biocompatibility and vascularization of biodegradable porous polyurethane scaffolds for tissue engineering. , 2009, Acta biomaterialia.

[28]  James Melrose,et al.  Mechanical Destabilization Induced by Controlled Annular Incision of the Intervertebral Disc Dysregulates Metalloproteinase Expression and Induces Disc Degeneration , 2012, Spine.