Morphometrical dimensions of the sheep thoracolumbar vertebrae as seen on digitised CT images

Ultrasound-guided quadratus lumborum block in sheep: A cadaveric study

This prospective anatomical study aimed to establish an ultrasound-guided technique to the quadratus lumborum (QL) plane in sheep cadavers. Thirteen cadavers, weighing less than 117 kg, were included. In phase 1, one cadaver underwent dissection and two cadavers underwent 3D computed tomographic reconstruction for anatomical evaluation of the thoracolumbar region. In phase 2, two cadavers were used to compare two ultrasound techniques to the QL plane: lateral to the QL muscle with a transversal approach (LQL) and transmuscular between QL and psoas muscles with a longitudinal approach (TQL). For LQL, the reference was the first lumbar transverse process, whereas for TQL, it was the intertransverse region between the first and second lumbar vertebrae. The needle was advanced in-plane towards the specific target for each technique and a total of four injections were performed using 0.4 ml kg-1 of a dye-lidocaine solution. In phase 3, 10 cadavers received bilateral LQL injections (n = 20). All cadavers were then dissected to evaluate spread of dye. In phase 2, following LQL injections, no dye was observed in undesired locations; however, the dye was noted in the retroperitoneal space (1/2) after TQL injections. In phase 3, the 13th thoracic, first, second, third lumbar nerves, and sympathetic trunk segments were stained in 80%, 95%, 100%, 45% and 35% of the injections, respectively. In conclusion, the LQL technique was feasible, allowing staining of the spinal nerves innervating the cranial abdomen in sheep cadavers. Further studies in live animals are warranted.

Range of motion of the mid-cervical spine: human versus goat

BACKGROUND

The goat cervical spine represents a promising alternative for human specimen in spinal implant testing, but the range of motion (ROM) of the spine is lacking. We aimed to evaluate and compare the ROMs of fresh goat and human mid-cervical spine specimens.

METHODS

Ten fresh adult healthy male goat cervical spine specimens (G group) and ten fresh frozen adult healthy human cervical spine specimens (average age: 49.5 ± 12.1 years; 6 males, 4 females) (H group) were included. The ROMs of each specimen were biomechanically tested at the C_2-3, C_3-4, C_4-5 and C_2-5 levels at 1.5 Nm and 2.5 Nm torque and recorded. The ROMs of different levels of goat cervical samples were compared to those of human cervical samples using an independent sample t test. Significance was defined as a P value of less than 0.05.

RESULTS

At the C_2-3, C_3-4 and C_4-5 levels, the ROMs of the goat cervical spine were significantly larger than those of the human cervical spine in all directions except extension under 1.5 Nm torque; under 2.5 Nm torque, the ROMs of the goat cervical spine at the C_2-3 and C_3-4 levels were significantly larger than those of humans in the pure movement of flexion, lateral bending and axial rotation, and the ROMs for axial rotation of the goat specimens and human specimens were comparable. Under both 1.5 Nm and 2.5 Nm torque, the goat cervical spine displayed a much greater ROM in all directions at the C_2-5 level.

CONCLUSIONS

Several segmental ROMs of fresh goat and human cervical spine specimens were recorded in this investigation. We recommend using goat cervical specimens as an alternative to fresh human cervical specimens in future studies when focusing only on the ROMs of C_2-3, C_3-4 and C_4-5 in flexion under a torque of 1.5 Nm or the ROMs of C_2-3 and C_3-4 in flexion and rotation under a torque of 2.5 Nm.

The Translational Benefits of Sheep as Large Animal Models of Human Neurological Disorders

The past two decades have seen a considerable rise in the use of sheep to model human neurological disorders. While each animal model has its merits, sheep have many advantages over small animal models when it comes to studies on the brain. In particular, sheep have brains more comparable in size and structure to the human brain. They also have much longer life spans and are docile animals, making them useful for a wide range of in vivo studies. Sheep are amenable to regular blood and cerebrospinal fluid sampling which aids in biomarker discovery and monitoring of treatment efficacy. Several neurological diseases have been found to occur naturally in sheep, however sheep can also be genetically engineered or experimentally manipulated to recapitulate disease or injury. Many of these types of sheep models are currently being used for pre-clinical therapeutic trials, particularly gene therapy, with studies from several models culminating in potential treatments moving into clinical trials. This review will provide an overview of the benefits of using sheep to model neurological conditions, and highlight naturally occurring and experimentally induced sheep models that have demonstrated translational validity.

Intervertebral Disc Regeneration Injection of a Cell-Loaded Collagen Hydrogel in a Sheep Model

Degenerated intervertebral discs (IVDs) were treated with autologous adipose-derived stem cells (ASC) loaded into an injectable collagen scaffold in a sheep model to investigate the implant's therapeutic potential regarding the progression of degeneration of previously damaged discs. In this study, 18 merino sheep were subjected to a 3-step minimally invasive injury and treatment model, which consisted of surgically induced disc degeneration, treatment of IVDs with an ASC-loaded collagen hydrogel 6 weeks post-operatively, and assessment of the implant's influence on degenerative tissue changes after 6 and 12 months of grazing. Autologous ASCs were extracted from subcutaneous adipose tissue and cultivated in vitro. At the end of the experiment, disc heights were determined by µ-CT measurements and morphological tissue changes were histologically examined.Histological investigations show that, after treatment with the ASC-loaded collagen hydrogel implant, degeneration-specific features were observed less frequently. Quantitative studies of the degree of degeneration did not demonstrate a significant influence on potential tissue regeneration with treatment. Regarding disc height analysis, at both 6 and 12 months after treatment with the ASC-loaded collagen hydrogel implant a stabilization of the disc height can be seen. A complete restoration of the intervertebral disc heights however could not be achieved.The reported injection procedure describes in a preclinical model a translational therapeutic approach for degenerative disc diseases based on adipose-derived stem cells in a collagen hydrogel scaffold. Further investigations are planned with the use of a different injectable scaffold material using the same test model.

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

PURPOSE

This work describes a minimally invasive damage model for ovine lumbar discs via partial nucleotomy using a posterolateral approach.

METHODS

Two cadavers were dissected to analyze the percutaneous corridor. Subsequently, 28 ovine had their annulus fibrosus punctured via awl penetration under fluoroscopic control and nucleus pulposus tissue removed via rongeur. Efficacy was assessed by animal morbidity, ease of access to T12-S1 disc spaces, and production of a mechanical injury as verified by discography, radiography, and histology.

RESULTS

T12-S1 were accessible with minimal nerve damage morbidity. Scar tissue sealed the disc puncture site in all animals within 6 weeks, withstanding 1 MP of intradiscal pressure. Partial nucleotomy led to a significant reduction in intervertebral disk height and an increased histological degeneration score.

CONCLUSION

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.

Safe corridor for the implantation of thoracolumbar pedicle screws in growing pigs: A morphometric study

The pig spine is widely used as a large animal model for preclinical research in human medicine to test new spinal implants and surgical procedures. Among them, pedicle screw is one of the most common method of fixation of those implants. However, the pedicle of the porcine vertebra is not as well defined and not as large as the pedicle of the human vertebra. Therefore, the position of the screw should be adapted to the pig and not merely transposed based on the literature on humans. The purpose of this study is to determine the characteristics of the optimum implantation corridors for pedicle screws in the thoracolumbar spine of piglets of different ages using computed tomography (CT) and to determine the size and length of these corridors in pigs of different ages. CT scans from five groups of age: 6, 10, 14, 18, and 26 weeks were reviewed. For each thoracolumbar vertebrae, the pedicle width, pedicle axis length, and the pedicle angle was measured for the left and right pedicle. A total of 326 thoracic vertebrae and 126 lumbar vertebrae were included in the study. Pedicles are statistically larger but not longer for the lumbar vertebrae. An important variation of the pedicle angle is observed along the spine. In all pigs, an abrupt modification of the pedicle angle between T10 and T11 was observed, which corresponds to the level of the anticlinal vertebra which is the vertebra for which the spinous process is nearly perpendicular to the vertebral body. In conclusion, this study provides a quantitative database of pedicle screw implantation corridors in pigs of different ages. When using pedicle screws in experimental studies in pigs, these results should be considered for selecting the most suitable implants for the study but also to ensure a correct and safer screw position. Improving study procedures may limit postoperative complications and pain, thereby limiting the use of live animals.

Morphometric measurement of the cervical spine for minimally invasive pedicle screw fixation using reverse engineering and three-dimensional reconstruction

BACKGROUND

Percutaneous cervical pedicle screw fixation has been proven to be an effective method of cervical screw instrumentation, which has the advantages of less invasiveness and low blood loss. Emerging evidence has indicated that the cervical spinous process plays an important role in percutaneous spine surgery. However, there is a limited amount of information on the fundamental research of pedicle and its associated imaging parameter measurement. The purpose of this study was to measure the anatomic data of the pedicle screw channel (PSC) using reverse engineering and three-dimensional reconstruction, and also to discuss the three-dimensional relationship between the cervical spinous process and the pedicle screw channel.

METHODS

Twenty adult subjects (10 males, 10 females, age range 19-46 years) were studied using the method of three-dimensional CT reconstruction and reverse engineering. The centrum was divided into 10 equal parts from front to back. The bisectors were defined as borderline depths of the centrum, from front to back, 100%, 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 10%, 0% of borderline depths were presented. Then, a 3D coordinate system was constructed to measure all the data, including the radius of the inscribed circle, the length of the PSC, the insertion angle, the distances from entry point to cervical spinous process and skin depth. All the indexes were measured from 70% to 90% borderline depth.

RESULTS

The radius of the inscribed circles from C₃ to C₇ at 90% borderline depth were 2.94 ± 0.55 mm, 3.04 ± 0.40 mm, 3.15 ± 0.36 mm, 3.28 ± 0.47 mm, 3.89 ± 0.54 mm, respectively. The lengths of the PSC were between 25 and 32 mm. The insertion angles for 70% to 90% borderline depth were 28.33°, 34.28°, 37.92°, respectively. The relationship between the PSC and spinous process was measured as the distance from the entry point to the end of the spinous process, which were, respectively, 26.91 mm, 28.18 mm, 30.03 mm, 35.67 mm, 41.99 mm from C₃ to C₇ .The distance from the skin to the entry point of C_3-7 increased gradually.

CONCLUSIONS

The measurements of this study could provide detailed information for percutaneous cervical screw fixation. The data of the relationship between the cervical spinous process and the pedicle screw channel present valuable technical information for the design, optimization and clinical application of the aiming device for percutaneous cervical pedicle screw fixation. Copyright © 2016 John Wiley & Sons, Ltd.

Morphometry of lumbar spinous process via three dimensional CT reconstruction in a Chinese population

To investigate the morphometric data of the lumbar spinous process dimensions in Chinese population. Forty-six adult subjects (22 males, 24 females, age range 26-45 years) were studied using the method of the three dimensional CT reconstruction in our hospital. The following parameters were measured: the distance between two adjacent spinous processes (DB), distance across the two adjacent spinous processes (DA), thickness of central of spinous processes (TC), thickness of the superior margin of spinous processes (TS), thickness of the inferior margin of spinous processes (TI), and height of spinous processes (H). Variance and correlation analysis were conducted for these data. Data met with normal distribution and homogeneity of variance. Similar variation trend of the parameters of lumbar spinous process for male and female was found. DB became shorter gradually from L1-2 to L4-5, and increased at the L5-S1. DA became larger from T12-L1 to L1-2 for male and L2-3 for female, and then became shorter from L1-2 for male and L2-3 for female, respectively. The largest H of male and female were both noted at L3. TS of the adjacent spinous processes were lower than that of TI for male and female. Statistical significance between male and female were found in H, TC, TS, TI (L1, L3 and L4), and DA (except for L4-5). Compared to male, the spinous processes of female were shorter, thinner and lower. These data may be useful for clinical application and the design of interspinous implant in Chinese population.

Is sheep lumbar spine a suitable alternative model for human spinal researches? Morphometrical comparison study

Sheep are commonly used as a model for human spinal orthopaedic research due to their similarity in morphological and biomechanical features. This study aimed to document the volumes of vertebral bodies and compare the generated results as well as morphometry of the sheep lumbar spine to human published data. For this purpose, computed tomography scans were carried out on five adult Merino sheep under general anaesthesia. Transverse 5 mm thick images were acquired from L1 to L6 using a multi-detector-row helical CT scanner. Volume measurements were performed with dedicated software. Four spinal indices and Pavlov's ratio were calculated. Thereafter, the generated data were compared to published literature on humans. The mean vertebral body volume showed an increase towards the caudal vertebrae, but there were no significant differences between the vertebral levels (P>0.05). Compared to humans, sheep vertebral body volumes were 48.6% smaller. The comparison of absolute values between both species revealed that sheep had smaller, longer and narrower vertebral bodies, thinner intervertebral discs, narrower spinal canal, longer transverse processes, shorter dorsal spinous processes and narrower, higher pedicles with more lateral angulations. The comparison of the spinal indices showed a good similarity to human in terms of the vertebral endplates and spinal canal. The results of this study may be helpful for using the sheep as a model for human orthopaedic spinal research if anatomical differences are taken into account.