2. Development of a fresh porcine cadaver ex vivo model using the L6/S1 spine segment for simulating intraoperative iatrogenic lumbar durotomy with nerve rootlet herniation during full-endoscopic spine surgery

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100696

Jui-Jung Yang MD, PhD

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Abstract

BACKGROUND CONTEXT

There was no effective technique for dural repair during full-endoscopic spine surgery (FESS). Our objective was to develop and evaluate porcine cadavers as an ex vivo animal model for simulating iatrogenic lumbar durotomy with nerve rootlet herniation during FESS.

PURPOSE

This model aims to reduce the reliance on live animals in experimental and training settings, facilitating the development of dural repair techniques.

STUDY DESIGN/SETTING

Ex vivo animal study.

PATIENT SAMPLE

N/A

OUTCOME MEASURES

N/A

METHODS

Fresh porcine lumbosacral segments were dissected to evaluate subdural nerve anatomy and identify traversing nerve rootlets suitable for herniation simulation. FESS was performed on cadaveric porcine spines using a uniportal interlaminar approach, progressing from L6/S1 to cephalic segments. A 0.5 cm dorsal dural defect was created to simulate an iatrogenic durotomy.

RESULTS

Anatomical evaluation and ex vivo durotomy simulation revealed that subdural traversing nerve rootlet fibers were identifiable only in the 1 or 2 most caudal segments (L5/6 and L6/S1), reflecting segmental differences in nerve rootlet orientation. No obvious endoscopic images from this ex vivo durotomy simulation at the most caudal segments (L6/S1) showed realistic gross appearances of the thecal sac and subdural nerve tissue. The nerve rootlet herniation from the dural defect effectively simulated iatrogenic durotomy during FESS.

CONCLUSIONS

The ex vivo porcine model for simulating lumbar iatrogenic durotomy with nerve rootlet herniation offers a realistic alternative to in vivo FESS models. With comparable anatomy and high realism, it reduces reliance on live animals, serving as a valuable platform for training and advancing dural repair techniques.

FDA Device/Drug Status

This abstract does not discuss or include any applicable devices or drugs.

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2. 利用L6/S1脊柱节段建立新鲜猪尸体离体模型，模拟全内窥镜脊柱手术中医源性腰椎硬膜切开术伴神经根突出

背景：在全内窥镜脊柱手术（FESS）中，没有有效的硬脑膜修复技术。我们的目的是开发和评估猪尸体作为体外动物模型来模拟医源性腰硬膜切开术伴神经根疝。目的：该模型旨在减少实验和训练中对活体动物的依赖，促进硬脑膜修复技术的发展。研究设计/设置离体动物研究。患者样本/结果测量/方法解剖新鲜猪腰骶段以评估硬膜下神经解剖，并确定适合疝模拟的穿越神经根。采用单门静脉椎间入路对尸体猪脊柱进行FESS，从L6/S1到头节段。创建一个0.5 cm的硬脑膜背侧缺损来模拟医源性硬脑膜切开术。结果解剖评估和离体硬脑膜切开模拟显示，硬脑膜下穿过神经根纤维仅在1或2个最尾端节段（L5/6和L6/S1）可见，反映了神经根定向的节段差异。在大多数尾节（L6/S1），体外硬膜切开模拟没有明显的内镜图像显示硬膜囊和硬膜下神经组织的真实大体外观。硬脑膜缺损神经根突出可有效模拟医源性硬脑膜切开术。结论猪离体模拟腰椎医源性硬膜切开术伴神经根疝的模型，是一种较现实的替代体外FESS模型。具有类似的解剖结构和高度的真实感，它减少了对活体动物的依赖，作为训练和推进硬脑膜修复技术的宝贵平台。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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