Collateral effects of targeting the nucleus pulposus via a transpedicular or transannular surgical route: a combined X-r
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ORIGINAL ARTICLE
Collateral effects of targeting the nucleus pulposus via a transpedicular or transannular surgical route: a combined X‑ray, MRI, and histological long‑term descriptive study in sheep 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 Guicheux1,3,10 · Marion Fusellier1,8 Received: 13 September 2019 / Revised: 2 September 2020 / Accepted: 7 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Intervertebral disc degeneration · Transpedicular approach · Transannular approach · Regenerative medicine
Introduction
Cyrille Decante, Johann Clouet: Co-first author * Jérôme Guicheux [email protected] 1
2
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 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
Low back pain (LBP) is an extremely frequent symptom and in 40% of cases it is associated with intervertebral disc (IVD) degenerative disease (DDD) [1–3]. Current therapies for LBP mainly manage the pain experienced by patients 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 Engi
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