k 2019

Mikro-CT, biomechanické a histologické zhodnocení průběhu intervertebrální lumbální dézy na experimentálním praseti. Porovnání kostního štěpu versus nově vyvinutého biodegradabilního nanokompozitního implantátu.

KRTIČKA, Milan, Ladislav PLÁNKA, Andrej BILIK, Daniel IRA, Vladimír NEKUDA et. al.

Basic information

Original name

Mikro-CT, biomechanické a histologické zhodnocení průběhu intervertebrální lumbální dézy na experimentálním praseti. Porovnání kostního štěpu versus nově vyvinutého biodegradabilního nanokompozitního implantátu.

Name (in English)

Microcomputed tomographic, biomechanical and histological analyses of lumbar interbody fusion in pig model: Comparison of iliac crest bone graft and newly developed hybrid biodegradable nanocomposit porous implant

Authors

KRTIČKA, Milan (203 Czech Republic, guarantor, belonging to the institution), Ladislav PLÁNKA (203 Czech Republic, belonging to the institution), Andrej BILIK (203 Czech Republic), Daniel IRA (703 Slovakia, belonging to the institution), Vladimír NEKUDA (203 Czech Republic, belonging to the institution), Radek SEDLÁČEK (203 Czech Republic), M. KAVKOVÁ (203 Czech Republic), A. BŘÍNEK (203 Czech Republic), E. GÖPFERT (203 Czech Republic) and Lucy VOJTOVÁ (203 Czech Republic)

Edition

Sborník přednášek: XI. MEZINÁRODNÍ KONGRES ÚRAZOVÉ CHIRURGIE A SOUDNÍHO LÉKAŘSTVÍ A NÁRODNÍ KONGRES ČESKÉ SPOLEČNOSTI ÚRAZOVÉ CHIRURGIE ČLS JEP, 2019

Other information

Language

Czech

Type of outcome

Prezentace na konferencích

Field of Study

30212 Surgery

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

RIV identification code

RIV/00216224:14110/19:00113208

Organization unit

Faculty of Medicine

Keywords (in Czech)

Mikro-CT; intervertebrální déza

Keywords in English

Mikro-CT; lumbar interbody fusion

Tags

rivok
Změněno: 24/4/2020 14:53, Mgr. Tereza Miškechová

Abstract

ORIG EN

V originále

Introduction: The use of lumbar fusion procedures in the USA and Europe has rapidly increased over the last decade and a large number of these procedures involve the use of bone grafts. Despite of technical progress of spinal surgery and operative materials the risk of vertebral fusion failure occurs in 5 – 35 % of cases. Autografting has been considered the gold standard for bone graft procedures. However, the harvesting from the iliac crest can be associated with short and long-term morbidity in up to 22 % of cases. Main goal of this experimental study was to compare newly developed hybrid biodegradable nanocomposit porous implant (HBNPI) against bone craft from iliac crest as a new and better alternative for lumbar interbody fusion. Material and methods: 24 male pigs 4 months old weighting around 40 Kg were included in our study. These pigs were divided into two study groups depending on fusion method. Group A – 12 pigs underwent lateral lumbal interbody fusion (L2/3) with implantation of iliac crest bonegraft. Group B - 12 pigs underwent lateral lumbal interbody fusion (L2/3) with newly developed HBNPI. Each group were divided into two subgroups from these 6 spines were harvested 8 weeks (subgroup A1, B1) and 6 spines 16 weeks (group A2, B2) after surgery. After sacrifice, the lumbar spines were taking out and micro-CT, biomechanical testing and histomorphological analysis in all groups were performed to evaluate a quality of intervertebral fusion. As controls (group N), 6 cadaveric intact lumbar spines underwent biomechanical, microCT and histological testing. Results: All 24 animals recovered from general anesthesia without unusual events. The operations lasted between 50-90 minutes (mean 70) in Group A and between 35-72 minutes (mean 43) in Group B. All of the pigs from group A could stand up and were mobile within 20 hours (range 7-20). When bone graft harvesting was not necessary (group B) this time was shortened, ranging from 1 – 1,5 hour. All pigs from Group A were limping on the first postoperative day. No limping animal was observed in group B. Total body weight of the pigs increased from 37 kg (range 36-40) at the start to 85 (range 80-89) at sacrifice. Biomechanics evaluation shows that extension flexural stiffness values are statistically significantly different between A2 (16 weeks post-implant) and A1 (8 weeks post- implant). Group A2 achieves higher values than Group A1, which is attributed to the adhesion of the implant to the surrounding vertebrae. Similarly, this also applies to groups B2 and B1. The flexural stiffness at group B2 extension is statistically significantly higher than the A2 group and also than the native N group. Biomechanical evaluation supports findings on microCT and histological specimens, where both adjacent vertebrae are completely fused in groups B2, unlike in group A2, where there is no or incomplete fusion. Conclusion: Newly developed HBNPI represents new possibility how to do intervertebral fusion, and simultaneous become chance how to improve and accelerate bone healing process against standard procedures.

In English

Introduction: The use of lumbar fusion procedures in the USA and Europe has rapidly increased over the last decade and a large number of these procedures involve the use of bone grafts. Despite of technical progress of spinal surgery and operative materials the risk of vertebral fusion failure occurs in 5 – 35 % of cases. Autografting has been considered the gold standard for bone graft procedures. However, the harvesting from the iliac crest can be associated with short and long-term morbidity in up to 22 % of cases. Main goal of this experimental study was to compare newly developed hybrid biodegradable nanocomposit porous implant (HBNPI) against bone craft from iliac crest as a new and better alternative for lumbar interbody fusion. Material and methods: 24 male pigs 4 months old weighting around 40 Kg were included in our study. These pigs were divided into two study groups depending on fusion method. Group A – 12 pigs underwent lateral lumbal interbody fusion (L2/3) with implantation of iliac crest bonegraft. Group B - 12 pigs underwent lateral lumbal interbody fusion (L2/3) with newly developed HBNPI. Each group were divided into two subgroups from these 6 spines were harvested 8 weeks (subgroup A1, B1) and 6 spines 16 weeks (group A2, B2) after surgery. After sacrifice, the lumbar spines were taking out and micro-CT, biomechanical testing and histomorphological analysis in all groups were performed to evaluate a quality of intervertebral fusion. As controls (group N), 6 cadaveric intact lumbar spines underwent biomechanical, microCT and histological testing. Results: All 24 animals recovered from general anesthesia without unusual events. The operations lasted between 50-90 minutes (mean 70) in Group A and between 35-72 minutes (mean 43) in Group B. All of the pigs from group A could stand up and were mobile within 20 hours (range 7-20). When bone graft harvesting was not necessary (group B) this time was shortened, ranging from 1 – 1,5 hour. All pigs from Group A were limping on the first postoperative day. No limping animal was observed in group B. Total body weight of the pigs increased from 37 kg (range 36-40) at the start to 85 (range 80-89) at sacrifice. Biomechanics evaluation shows that extension flexural stiffness values are statistically significantly different between A2 (16 weeks post-implant) and A1 (8 weeks post- implant). Group A2 achieves higher values than Group A1, which is attributed to the adhesion of the implant to the surrounding vertebrae. Similarly, this also applies to groups B2 and B1. The flexural stiffness at group B2 extension is statistically significantly higher than the A2 group and also than the native N group. Biomechanical evaluation supports findings on microCT and histological specimens, where both adjacent vertebrae are completely fused in groups B2, unlike in group A2, where there is no or incomplete fusion. Conclusion: Newly developed HBNPI represents new possibility how to do intervertebral fusion, and simultaneous become chance how to improve and accelerate bone healing process against standard procedures.
Displayed: 31/10/2024 20:01