Revistas
Revista:
GLOBAL SPINE JOURNAL
ISSN:
2192-5682
Año:
2023
Vol.:
13
N°:
1
Págs.:
156 - 163
Study Design: Animal experimental model. Objective: To study the clinical behavior and histological changes in the spinal cord, nerve roots and perivertebral muscles of the spine after induced leakage of polymethylmethacrylate (PMMA) loaded with antiblastic drugs during vertebroplasty in an animal model of pigs. Methods: We performed vertebroplasty on 25 pigs. The animals were divided into 3 groups: vertebroplasty with PMMA alone (control group), vertebroplasty with PMMA loaded with methotrexate (MTX) and vertebroplasty with PMMA loaded with cisplatin (CYS). At 2 vertebral levels, epidural and prevertebral, massive cement leaks were induced. Animals were evaluated daily. Two weeks later, the pigs were sacrificed, and the tissues that came in contact with the cement were analyzed. Results: The clinical results for each of the groups were reported. The control group had no clinical alterations. In the MTX group, 2 pigs died before 1 week due to pneumonitis. In the CYS group, 4 animals had motor impairment, and 3 of the 4 had paraplegia. The histological results were as follows: the control and MTX groups showed synovial metaplasia, inflammatory reaction, crystal deposits, and giant cell reaction in the dura mater and muscle and all the animals in the CYS group had spinal cord and muscular necrosis. Conclusions: Massive cement leak after vertebroplasty with PMMA loaded with cisplatin is extremely toxic to the spinal cord and muscles around the spine. Therefore, its use cannot be recommended for the treatment of vertebral metastases. Using PMMA loaded with methotrexate seems to be a safe procedure, but further research is needed.
Revista:
ASIAN SPINE JOURNAL
ISSN:
1976-1902
Año:
2013
Vol.:
7
N°:
3
Págs.:
159-166
The spinal cord was normal; it is likely that dura mater and cerebrospinal fluid are responsible to isolate neural structures from cement. Dura mater and muscle showed similar histological changes than other publications. Synovial metaplasia was observed in dura mater and muscles that came into contact with cement. The pulsatile rubbing between the tissue and cement could be responsible of this phenomenon.
Revista:
European Spine Journal
ISSN:
0940-6719
Año:
2011
Vol.:
20
N°:
2
Págs.:
338 - 339
Study Design: Prospective, experimental study in animals, approved by the local ethics committee for animal research.
Aims: To evaluate and compare the histological changes in myeloradicular structures and paravertebral tissue induced by contact with acrylic cement with and without methotrexate in vertebroplasty in pigs.
Material and Methods: Ten female pigs of the Large White¿Landrace breed, weighing 30 kg and divided into two groups: control group, containing five pigs that underwent vertebroplasty with acrylic cement, and methotrexate group, with five pigs that underwent vertebroplasty using cement combined with 1 g of methotrexate. A standard fluoroscopy-guide transpedicular vertebroplasty technique was performed with an 11-G trocar. Cement leak to the prevertebral and epidural muscle tissue was induced in two different lumbar vertebrae; 1 cc of cement was injected per vertebra. Animals were sacrificed at 3 weeks. Spines were removed, the section where tissues were in contact with cement was isolated by dissection, the surface in direct contact with cement was marked with India ink, and specimens were processed by fixation and hematoxylin eosin staining for pos-terior microscopic study.
Results: Macroscopic results: In both groups, the cement was distributed in layers surrounding the dural sac. Histological results: In the control group, leakage to the prevertebral musculature with atrophy of muscle fibers, inflammatory infiltrate in areas in contact with cement, epithelial dysplasia, and foreign body reaction in relation to cement particles. In addition, epidural leak with dural thickening and inflammatory reaction only in areas of the dura mater in contact with cement. In the methotrexate group, the same changes as in the control group were observed.
Clinical results: Neurological lesion due to cement leak was not produced any of the ten pigs.
Conclusions:The tube-like laminar distribution of the cement may explain the fact that there was an absence of paraplegia in the study animals. Contact of the muscle and dura with cement seemed to induce an inflammatory reaction, with cell death, and atrophy and thickening of membranes in some cases. Addition of methotrexate to acrylic cement did not seem to increase the local toxicity of cement alone.
Revista:
European Spine Journal
ISSN:
0940-6719
Año:
2011
Vol.:
20
N°:
2
Págs.:
338
Revista:
European Spine Journal
ISSN:
0940-6719
Año:
2011
Vol.:
20
Págs.:
310 - 340