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01-08-2017 | Original Article

The transpedicular surgical approach for the development of intervertebral disc targeting regenerative strategies in an ovine model

Authors: Luc Le Fournier, Marion Fusellier, Boris Halgand, Julie Lesoeur, Olivier Gauthier, Philippe Menei, Claudia Montero-Menei, Jérôme Guicheux, Johann Clouet

Published in: European Spine Journal | Issue 8/2017

Abstract

Purpose

To investigate the suitability of the transpedicular approach (TPA) in a sheep model of IVD regenerative strategies

Methods

24 IVD from four sheep were used. TPA and biopsies of the Nucleus pulposus (NP) were performed in 18 IVD (6 IVD control). Seven discographies were performed to assess the feasibility of injecting contrast agent. MRI, micro-CT scan, and histological analyses were performed and the accuracy of the TPA was evaluated. The effects on the vertebra and endplates were analyzed.

Results

83% of our biopsies or injections were located in the NP. Osseous fragments in IVD were observed in 50%. We observed two cases (11%) of rostral endplate fracture and five cases (27%) of breaching of the cortical pedicle and encroachment into the spinal canal. Two cases of perivertebral venous embolism and two of backflow through the canal of the TPA inside the vertebra were noted. Significant damage occurred to the bone structure of the vertebra and to the rostral endplate on which the IVD had been inserted.

Conclusions

TPA induces damage to the endplates, and it may lead to neurological impairment and leakage of injected materials into the systemic circulation. These adverse effects must be fully considered before proceeding with TPA for IVD regenerative strategies.

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Title: The transpedicular surgical approach for the development of intervertebral disc targeting regenerative strategies in an ovine model
Authors: Luc Le Fournier
Marion Fusellier
Boris Halgand
Julie Lesoeur
Olivier Gauthier
Philippe Menei
Claudia Montero-Menei
Jérôme Guicheux
Johann Clouet
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-5199-z

At a glance: The STEP trials

Springer Medicine

The transpedicular surgical approach for the development of intervertebral disc targeting regenerative strategies in an ovine model

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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