Year: 2019
Type: dissertation
Abstract: Osteoporotic vertebral fractures represent an important health burden in the Western world, in particular given the aging population demographics of most Western countries. At present, the treatment options for osteoporotic vertebral fractures are limited, and often conservative, relying on medical pain management. Transpedicular spinal interventional techniques such as vertebroplasty and kyphoplasty offer a minimally invasive treatment option for osteoporotic vertebral fractures. However, there has been recent controversy regarding the efficacy of vertebroplasty for pain relief. Although these percutaneous techniques continue to be used and developed, there is no consensus on the pre-clinical testing of new instruments and cements. Human cadaveric vertebrae are expensive and of limited availability, and animal vertebrae offer a more easily accessible alternative, but there is no agreement within the literature as to which species best approximates the human. \nThis thesis explores the currently available evidence comparing human and animal vertebrae, and performs comparison studies assessing basic morphometric measurements, bone texture, and statistical shape analysis, to decide upon the best animal model for the use in assessing novel transpedicular instruments and vertebral bone cements. The findings would also apply to developments in surgical transpedicular screws. \nThe morphometry showed that sheep are generally closer to humans in the thoracic spine, whereas pigs are closer in the lumbar spine. Bone texture analysis demonstrated no significant differences in trabecular thickness between humans and either sheep or pigs. Statistical shape analysis corroborated the findings of basic morphometry. Taking the findings in combination, I would suggest that for the purposes of transpedicular techniques, the sheep is a closer model to the human in the thoracic spine, and the pig is closer in the lumbar spine.
Author: Timothy Ariyanayagam
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3013660208