Cyrille Decante1,2, Johann Clouet1,3,4,5, Antoine Hamel1,2, Luc Le Fournier6, Olivier Gauthier1,7, Dominique Rouleau1,8, Julie Lesoeur1,3, Boris Halgand1,3,9, Catherine Le Visage1, Jérôme Guicheux10,11,12, Marion Fusellier1,8. 1. INSERM UMR 1229, RMeS, Regenerative Medicine and Skeleton, School of Dental Surgery, ONIRIS, Université de Nantes, 1-Place Alexis Ricordeau, 44042, Nantes Cedex I, France. 2. CHU Nantes, PHU5 HME Chirurgie Infantile, 44093, Nantes, France. 3. UFR Odontologie, Université de Nantes, 44042, Nantes, France. 4. UFR Sciences Biologiques et Pharmaceutiques, Université de Nantes, 44035, Nantes, France. 5. CHU Nantes, Pharmacie Centrale, PHU11, 44093, Nantes, France. 6. Department of Neurosurgery, CHU Angers, 49033, Angers, France. 7. Department of Surgery,CRIP, Oniris College of Veterinary Medicine, Food Science and Engineering, 44307, Nantes, France. 8. Department of Diagnostic Imaging, CRIP, Oniris College of Veterinary Medicine, Food Science and Engineering, 44307, Nantes, France. 9. CHU Nantes, 44093, Nantes, France. 10. INSERM UMR 1229, RMeS, Regenerative Medicine and Skeleton, School of Dental Surgery, ONIRIS, Université de Nantes, 1-Place Alexis Ricordeau, 44042, Nantes Cedex I, France. jerome.guicheux@inserm.fr. 11. UFR Odontologie, Université de Nantes, 44042, Nantes, France. jerome.guicheux@inserm.fr. 12. CHU Nantes, PHU4 OTONN, 44093, Nantes, France. jerome.guicheux@inserm.fr.
Abstract
PURPOSE: In the context of regenerative medicine strategies, based in particular on the injection of regenerative cells, biological factors, or biomaterials into the nucleus pulposus (NP), two main routes are used: the transpedicular approach (TPA) and the transannular approach (TAA). The purpose of our study was to compare the long-term consequences of the TPA and the TAA on intervertebral disc (IVD) health through a longitudinal follow-up in an ovine model. METHODS: The TPA and the TAA were performed on 12 IVDs from 3 sheep. Six discs were left untreated and used as controls. The route and injection feasibility, as well as the IVD environment integrity, were assessed by MRI (T2-weighted signal intensity), micro-CT scan, and histological analyses (Boos' scoring). The sheep were assessed at 1, 3, and 7 months. RESULTS: Both the TPA and the TAA allowed access to the NP. They both induced NP degeneration, as evidenced by a decrease in the T2wsi and an increase in the Boos' scores. The TPA led to persistent end-plate defects and herniation of NP tissue (Schmorl's node-like) after 7 months as well as the presence of osseous fragments in the NP. CONCLUSIONS: The TPA induced more severe lesions in IVDs and vertebrae compared to the TAA. The lesions induced by the TPA are reason to consider whether or not this route is optimal for studying IVD regenerative medicine approaches.
PURPOSE: In the context of regenerative medicine strategies, based in particular on the injection of regenerative cells, biological factors, or biomaterials into the nucleus pulposus (NP), two main routes are used: the transpedicular approach (TPA) and the transannular approach (TAA). The purpose of our study was to compare the long-term consequences of the TPA and the TAA on intervertebral disc (IVD) health through a longitudinal follow-up in an ovine model. METHODS: The TPA and the TAA were performed on 12 IVDs from 3 sheep. Six discs were left untreated and used as controls. The route and injection feasibility, as well as the IVD environment integrity, were assessed by MRI (T2-weighted signal intensity), micro-CT scan, and histological analyses (Boos' scoring). The sheep were assessed at 1, 3, and 7 months. RESULTS: Both the TPA and the TAA allowed access to the NP. They both induced NP degeneration, as evidenced by a decrease in the T2wsi and an increase in the Boos' scores. The TPA led to persistent end-plate defects and herniation of NP tissue (Schmorl's node-like) after 7 months as well as the presence of osseous fragments in the NP. CONCLUSIONS: The TPA induced more severe lesions in IVDs and vertebrae compared to the TAA. The lesions induced by the TPA are reason to consider whether or not this route is optimal for studying IVD regenerative medicine approaches.
Authors: James S Harrop; Jim A Youssef; Mitch Maltenfort; Peggy Vorwald; Pascal Jabbour; Christopher M Bono; Neil Goldfarb; Alexander R Vaccaro; Alan S Hilibrand Journal: Spine (Phila Pa 1976) Date: 2008-07-01 Impact factor: 3.468
Authors: Mauro Alini; Stephen M Eisenstein; Keita Ito; Christopher Little; A Annette Kettler; Koichi Masuda; James Melrose; Jim Ralphs; Ian Stokes; Hans Joachim Wilke Journal: Eur Spine J Date: 2007-07-14 Impact factor: 3.134