Open AccessSpinal fixation after laminectomy in pigs prevents postoperative spinal cord injury
Author(s) -
Slot Emma M. H.,
Boer Bart,
Redegeld Saskia,
Thoor Sander,
Moayeri Nizar,
Slooff WillemBart,
Schaafsma Irene A.,
Meij Björn,
Doormaal Tristan P. C.
Publication year - 2022
Publication title -
animal models and experimental medicine
Language(s) - English
Resource type - Journals
ISSN - 2576-2095
DOI - 10.1002/ame2.12213
Subject(s) - medicine , spinal cord , decompression , spinal cord compression , laminectomy , magnetic resonance imaging , surgery , fixation (population genetics) , spinal cord injury , spinal decompression , hematoma , lumbar , myelopathy , anesthesia , radiology , psychiatry , population , environmental health
Background A safe, effective, and ethically sound animal model is essential for preclinical research to investigate spinal medical devices. We report the initial failure of a porcine spinal survival model and a potential solution by fixating the spine. Methods Eleven female Dutch Landrace pigs underwent a spinal lumbar interlaminar decompression with durotomy and were randomized for implantation of a medical device or control group. Magnetic resonance imaging (MRI) was performed before termination. Results Neurological deficits were observed in 6 out of the first 8 animals. Three of these animals were terminated prematurely because they reached the predefined humane endpoint. Spinal cord compression and myelopathy was observed on postoperative MRI imaging. We hypothesized postoperative spinal instability with epidural hematoma, inherent to the biology of the model, and subsequent spinal cord injury as a potential cause. In the subsequent 3 animals, we fixated the spine with Lubra plates. All these animals recovered without neurological deficits. The extent of spinal cord compression on MRI was variable across animals and did not seem to correspond well with neurological outcome. Conclusion This study shows that in a porcine in vivo model of interlaminar decompression and durotomy, fixation of the spine after lumbar interlaminar decompression is feasible and may improve neurological outcomes. Additional research is necessary to evaluate this hypothesis.