Continuous distraction-induced delayed spinal cord injury on motor-evoked potentials and histological changes of spinal cord in a porcine model

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Abstract

Study design:Experimental study.Objectives:This study evaluated distraction-induced delayed spinal cord injury in a porcine model.Setting:Department of Orthopedics, Korea University Guro Hospital, Seoul, Korea.Methods:Global osteotomy of three columns was performed on the thirteenth thoracic vertebrae with 13 pigs. The osteotomized vertebrae were distracted to 57–103% of segmental vertebral height (SVH) length, which was less than the distraction length that induces prompt SCI. The vertebral height was maintained until the loss of motor-evoked potential (MEP) signals with continuous distraction. The distraction distance and the time at which SCI occurred were measured, and distraction was then released to observe MEP recovery patterns.Results:We found delayed SCI in 8 of the 12 pigs, with a mean 20.9 mm (range 19–25 mm) and 10.7 min (range 8–12 min) of continuous spinal distraction, which was equivalent to 74.3% (68–84%) of SVH and 3.63% (3.42–4.31%) of thoracolumbar spinal length. A continuous 74.3% SVH distraction over an average of 10.7 min caused a delayed SCI, which was indicated by mild histologic changes in the spinal cord. Recovery patterns from SCI after distraction release were compatible with the degree of histological change; however, these patterns differed from the previously investigated prompt type of SCI.Conclusion:Late onset injury due to continuous spinal distraction, which is comparable to iatrogenic SCI in spinal correction surgery, is important for understanding the impact of corrective surgery.Spinal Cord advance online publication, 19 January 2016; doi:10.1038/sc.2015.231.

Original languageEnglish
JournalSpinal Cord
DOIs
Publication statusAccepted/In press - 2016 Jan 19

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Motor Evoked Potentials
Spinal Cord Injuries
Spinal Cord
Swine
Korea
Thoracic Vertebrae
Osteotomy
Orthopedics
Publications
Spine
Research Design
Wounds and Injuries

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

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title = "Continuous distraction-induced delayed spinal cord injury on motor-evoked potentials and histological changes of spinal cord in a porcine model",
abstract = "Study design:Experimental study.Objectives:This study evaluated distraction-induced delayed spinal cord injury in a porcine model.Setting:Department of Orthopedics, Korea University Guro Hospital, Seoul, Korea.Methods:Global osteotomy of three columns was performed on the thirteenth thoracic vertebrae with 13 pigs. The osteotomized vertebrae were distracted to 57–103{\%} of segmental vertebral height (SVH) length, which was less than the distraction length that induces prompt SCI. The vertebral height was maintained until the loss of motor-evoked potential (MEP) signals with continuous distraction. The distraction distance and the time at which SCI occurred were measured, and distraction was then released to observe MEP recovery patterns.Results:We found delayed SCI in 8 of the 12 pigs, with a mean 20.9 mm (range 19–25 mm) and 10.7 min (range 8–12 min) of continuous spinal distraction, which was equivalent to 74.3{\%} (68–84{\%}) of SVH and 3.63{\%} (3.42–4.31{\%}) of thoracolumbar spinal length. A continuous 74.3{\%} SVH distraction over an average of 10.7 min caused a delayed SCI, which was indicated by mild histologic changes in the spinal cord. Recovery patterns from SCI after distraction release were compatible with the degree of histological change; however, these patterns differed from the previously investigated prompt type of SCI.Conclusion:Late onset injury due to continuous spinal distraction, which is comparable to iatrogenic SCI in spinal correction surgery, is important for understanding the impact of corrective surgery.Spinal Cord advance online publication, 19 January 2016; doi:10.1038/sc.2015.231.",
author = "Jae-Young Hong and Seung-Woo Suh and Lee, {S. H.} and Jung-Ho Park and Park, {Si Young} and Rhyu, {Im Joo} and Yang, {J. H.}",
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AU - Hong, Jae-Young

AU - Suh, Seung-Woo

AU - Lee, S. H.

AU - Park, Jung-Ho

AU - Park, Si Young

AU - Rhyu, Im Joo

AU - Yang, J. H.

PY - 2016/1/19

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N2 - Study design:Experimental study.Objectives:This study evaluated distraction-induced delayed spinal cord injury in a porcine model.Setting:Department of Orthopedics, Korea University Guro Hospital, Seoul, Korea.Methods:Global osteotomy of three columns was performed on the thirteenth thoracic vertebrae with 13 pigs. The osteotomized vertebrae were distracted to 57–103% of segmental vertebral height (SVH) length, which was less than the distraction length that induces prompt SCI. The vertebral height was maintained until the loss of motor-evoked potential (MEP) signals with continuous distraction. The distraction distance and the time at which SCI occurred were measured, and distraction was then released to observe MEP recovery patterns.Results:We found delayed SCI in 8 of the 12 pigs, with a mean 20.9 mm (range 19–25 mm) and 10.7 min (range 8–12 min) of continuous spinal distraction, which was equivalent to 74.3% (68–84%) of SVH and 3.63% (3.42–4.31%) of thoracolumbar spinal length. A continuous 74.3% SVH distraction over an average of 10.7 min caused a delayed SCI, which was indicated by mild histologic changes in the spinal cord. Recovery patterns from SCI after distraction release were compatible with the degree of histological change; however, these patterns differed from the previously investigated prompt type of SCI.Conclusion:Late onset injury due to continuous spinal distraction, which is comparable to iatrogenic SCI in spinal correction surgery, is important for understanding the impact of corrective surgery.Spinal Cord advance online publication, 19 January 2016; doi:10.1038/sc.2015.231.

AB - Study design:Experimental study.Objectives:This study evaluated distraction-induced delayed spinal cord injury in a porcine model.Setting:Department of Orthopedics, Korea University Guro Hospital, Seoul, Korea.Methods:Global osteotomy of three columns was performed on the thirteenth thoracic vertebrae with 13 pigs. The osteotomized vertebrae were distracted to 57–103% of segmental vertebral height (SVH) length, which was less than the distraction length that induces prompt SCI. The vertebral height was maintained until the loss of motor-evoked potential (MEP) signals with continuous distraction. The distraction distance and the time at which SCI occurred were measured, and distraction was then released to observe MEP recovery patterns.Results:We found delayed SCI in 8 of the 12 pigs, with a mean 20.9 mm (range 19–25 mm) and 10.7 min (range 8–12 min) of continuous spinal distraction, which was equivalent to 74.3% (68–84%) of SVH and 3.63% (3.42–4.31%) of thoracolumbar spinal length. A continuous 74.3% SVH distraction over an average of 10.7 min caused a delayed SCI, which was indicated by mild histologic changes in the spinal cord. Recovery patterns from SCI after distraction release were compatible with the degree of histological change; however, these patterns differed from the previously investigated prompt type of SCI.Conclusion:Late onset injury due to continuous spinal distraction, which is comparable to iatrogenic SCI in spinal correction surgery, is important for understanding the impact of corrective surgery.Spinal Cord advance online publication, 19 January 2016; doi:10.1038/sc.2015.231.

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