Skip to main content

Advertisement

SpringerLink
Log in

CT-guided injection technique into intervertebral discs in the ovine lumbar spine

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Disc injection to create intervertebral (IVD) disc degeneration (IVDD) has been reported in ovine models, but the techniques have not been thoroughly described. The current ex vivo study aimed to evaluate a computed tomography (CT)-guided injection technique into IVDs in the ovine lumbar spine.

Methods

Insertion of needles into the nucleus pulposus was assessed by gross anatomic dissection in two lumbar segments (group A), and injection of liquid within the disc was assessed by discography in six segments (group B).

Results

The pathway of the needle was simulated on computer after an initial CT scan, followed by control of the insertion process via a laser beam and monitoring scans. In group A, 20 insertions were assessed and 17 needles (85 %) were successfully positioned in the nucleus pulposus. In group B of 30 injections, the rate of success was 90 %.

Conclusions

The current study provides useful clinical information that will help surgeons working with an ovine model for research on IVDD. This model could also be useful to train less experienced surgeons or radiologists to disc injection. This CT-guided injection seems to offer several advantages such as ease of use, good success rate and safety to important nervous and vascular structures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kroeber MW, Unglaub F, Wang H et al (2002) New in vivo animal model to create intervertebral disc degeneration and to investigate the effects of therapeutic strategies to stimulate disc regeneration. Spine 27:2684–2690

    Article  PubMed  Google Scholar 

  2. Lotz JC (2004) Animal models of intervertebral disc degeneration: lessons learned. Spine 29:2742–2750

    Article  PubMed  Google Scholar 

  3. Wang YH, Kuo TF, Wang JL (2007) The implantation of non-cell-based materials to prevent the recurrent disc herniation: an in vivo porcine model using quantitative discomanometry examination. Eur Spine J 16:1021–1027

    Article  PubMed  Google Scholar 

  4. Omlor GW, Nerlich AG, Wilke H-J et al (2009) A new porcine in vivo animal model of disc degeneration: response of annulus fibrosus cells, chondrocyte-like nucleus pulposus cells, and notochordal nucleus pulposus cells to partial nucleotomy. Spine 34:2730–2739

    Article  PubMed  Google Scholar 

  5. Omlor GW, Nerlich AG, Lorenz H et al (2012) Injection of a polymerized hyaluronic acid/collagen hydrogel matrix in an in vivo porcine disc degeneration model. Eur Spine J 21:1700–1708

    Article  PubMed  CAS  Google Scholar 

  6. Spencer DL, Miller JA, Schultz AB (1985) The effects of chemonucleolysis on the mechanical properties of the canine lumbar disc. Spine 10:555–561

    Article  PubMed  CAS  Google Scholar 

  7. Fry TR, Eurell JC, Johnson AL et al (1991) Radiographic and histologic effects of chondroitinase ABC on normal canine lumbar intervertebral disc. Spine 16:816–819

    Article  PubMed  CAS  Google Scholar 

  8. Hoogendoorn RJ, Helder MN, Kroeze RJ et al (2008) Reproducible long-term disc degeneration in a large animal model. Spine 33:949–954

    Article  PubMed  Google Scholar 

  9. Kong J, Wang ZX, Ji AY et al (2008) A model of lumbar disc degeneration on the early stage in rhesus monkey with minimally invasive technique. Zhonghua Wai Ke Za Zhi 46:835–838

    PubMed  Google Scholar 

  10. Xi Yongming, Kong Jie, Liu Yong et al (2013) Minimally invasive induction of an early lumbar disc degeneration model in Rhesus monkeys. Spine 38:579–586

    Article  Google Scholar 

  11. Sasaki M, Takahashi T, Miyahara K et al (2001) Effects of chondroitinase ABC on intradiscal pressure in sheep: an in vivo study. Spine 26:463–468

    Article  PubMed  CAS  Google Scholar 

  12. Zhou H, Hou S, Shang W et al (2007) A new in vivo animal model to create intervertebral disc degeneration characterized by MRI, radiography, CT/discogram, biochemistry, and histology. Spine 32:864–872

    Article  PubMed  Google Scholar 

  13. Fazzalari NL, Costi JJ, Hearn TC et al (2001) Mechanical and pathologic consequences of induced concentric anular tears in an ovine model. Spine 26:2575–2581

    Article  PubMed  CAS  Google Scholar 

  14. Elliott DM, Yerramalli CS, Beckstein JC et al (2008) The effect of relative needle diameter in puncture and sham injection animal models of degeneration. Spine 33:588–596

    Article  PubMed  Google Scholar 

  15. Guder E, Hill S, Kandziora F, Schnake KJ (2009) Partial nucleotomy of the ovine disc as an in vivo model for disc degeneration. Z Orthop Unfall 147:52–58

    Article  PubMed  CAS  Google Scholar 

  16. Benz K, Stippich C, Fischer L et al (2012) Intervertebral disc cell- and hydrogel-supported and spontaneous intervertebral disc repair in nucleotomized sheep. Eur Spine J 21:1758–1768

    Article  PubMed  Google Scholar 

  17. Gangi A, Dietemann JL, Mortazavi R et al (1998) CT-guided interventional procedures for pain management in the lumbosacral spine. Radiographics 18:621–633

    Article  PubMed  CAS  Google Scholar 

  18. Koga H, Yone K, Yamamoto T et al (2003) Percutaneous CT-guided puncture and steroid injection for the treatment of lumbar discal cyst: a case report. Spine 28:212–216

    Google Scholar 

  19. Lotz JC, Haughton V, Boden SD et al (2012) New treatments and imaging strategies in degenerative disease of the intervertebral disks. Radiology 264:6–19

    Article  PubMed  Google Scholar 

  20. Barone R (1968) Articulations du rachis. In: Barone R (ed) Anatomie comparée des mammifères domestiques. Laboratoire d’anatomie, Lyon, pp 45–79

    Google Scholar 

  21. Barone R (1968) Muscles de l’abdomen. In: Barone R (ed) Anatomie comparée des mammifères domestiques. Laboratoire d’anatomie, Lyon, pp 687–737

    Google Scholar 

  22. Wilke HJ, Kettler A, Wenger KH et al (1997) Anatomy of the sheep spine and its comparison to the human spine. Anat Rec 247:542–555

    Article  PubMed  CAS  Google Scholar 

  23. Alini M, Eisenstein SM, Ito K et al (2008) Are animal models useful for studying human disc disorders/degeneration? Eur Spine J 17:2–19

    Article  PubMed  Google Scholar 

  24. Harnsberger O, Macdonald R (2006) Vertebral column, discs, paraspinal muscle. In: Harnsberger O, Macdonald R (eds) Diagnostic and surgical Imaging anatomy. Amirsys, Salt lake City, pp 104–127

    Google Scholar 

  25. Brown DJ, Wolcott ML, Crook BJ (2000) The measurement of skin thickness in Merino sheep using real time ultrasound. Wool Technol Sheep Breed 48:269

    Google Scholar 

  26. Sen AR, Santra A, Karim SA (2004) Carcass yield, composition and meat quality attributes of sheep and goat under semiarid conditions. Meat Sci 66:757–763

    Article  PubMed  CAS  Google Scholar 

  27. Keorochana G, Johnson JS, Taghavi CE et al (2010) The effect of needle size inducing degeneration in the rat caudal disc: evaluation using radiograph, magnetic resonance imaging, histology, and immunohistochemistry. Spine J 10:1014–1023

    Article  PubMed  Google Scholar 

  28. Michalek AJ, Buckley MR, Bonassar LJ et al (2010) The effects of needle puncture injury on microscale shear strain in the intervertebral disc annulus fibrosus. Spine J 10:1098–1105

    Article  PubMed  Google Scholar 

  29. Iatridis JC, Michalek AJ, Purmessur D et al (2009) Localized intervertebral disc injury leads to organ level changes in structure, cellularity, and biosynthesis. Cell Mol Bioeng 2:437–447

    Article  PubMed  Google Scholar 

  30. Elliott DM, Yerramalli CS, Beckstein JC et al (2008) The effect of relative needle diameter in puncture and sham injection animal models of degeneration. Spine 33:588–596

    Article  PubMed  Google Scholar 

  31. Mao HJ, Chen QX, Han B et al (2011) The effect of injection volume on disc degeneration in a rat-tail model. Spine 36:1062–1069

    Article  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Centre Hospitalier Universitaire Mont Godinne, Université Catholique de Louvain, Yvoir, Belgium

    Jean Francois Nisolle

  2. Department of Veterinary Medicine, Faculty of Sciences, Integrated Veterinary Research Unit-Namur Research Institute for Life Sciences (IRVU-NARILIS), University of Namur, Namur, Belgium

    Fabienne Neveu, Fanny Hontoir, Nathalie Kirschvink & Jean-Michel Vandeweerd

  3. Department of Musculoskeletal Biology, University of Liverpool, Leahurst Campus, Neston, UK

    Peter Clegg

Authors
  1. Jean Francois Nisolle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fabienne Neveu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fanny Hontoir
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter Clegg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nathalie Kirschvink
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean-Michel Vandeweerd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Michel Vandeweerd.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nisolle, J.F., Neveu, F., Hontoir, F. et al. CT-guided injection technique into intervertebral discs in the ovine lumbar spine. Eur Spine J 22, 2760–2765 (2013). https://doi.org/10.1007/s00586-013-2936-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2936-9

Keywords

Search

Navigation