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

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Abstract

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.

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Acknowledgement

The authors would like to thank W. Petzold and M. Menzel for technical assistance. Our special thanks go to the staff of the Animal Core Unit of the Translational Centre of Regenerative Medicine TRM, our keeper S. Köhler and veterinary assistant M. Köberle. The work presented in this paper was made possible by funding from the German Federal Ministry of Education and Research (BMBF, 1315883), the DAAD internship program RISE, and the Whitaker Biomedical Engineering Research Fellowship.

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Authors and Affiliations

  1. Translational Centre of Regenerative Medicine TRM, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany

    Stefan Schwan, Christopher Ludtka, Andre Baerthel, Andrea Friedmann & Felix Göhre

  2. Department of Biological and Macromolecular Materials, Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Walter-Hülse-Str. 1, 06120, Halle (Saale), Germany

    Stefan Schwan, Christopher Ludtka & Andrea Friedmann

  3. Department of Chemical and Biomolecular Engineering, University of Tennessee Knoxville, Knoxville, TN, USA

    Christopher Ludtka

  4. Department of General, Visceral and Vascular Surgery, BG-Klinik Bergmannstrost, Halle (Saale), Germany

    Ingo Wiesner

  5. Department of Neurosurgery, BG-Klinik Bergmannstrost, Halle (Saale), Germany

    Felix Göhre

  6. Department of Neurosurgery, Helsinki University Central Hospital, Helsinki University, Helsinki, Finland

    Felix Göhre

Authors
  1. Stefan Schwan
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  2. Christopher Ludtka
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  3. Ingo Wiesner
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  4. Andre Baerthel
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Correspondence to Stefan Schwan.

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Schwan, S., Ludtka, C., Wiesner, I. et al. Percutaneous posterolateral approach for the simulation of a far-lateral disc herniation in an ovine model. Eur Spine J 27, 222–230 (2018). https://doi.org/10.1007/s00586-017-5362-6

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  • DOI: https://doi.org/10.1007/s00586-017-5362-6

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