A novel minimally invasive and versatile kyphoplasty balloon-based model of porcine spinal cord injury

Sean M Barber; Tatiana Wolfe; Alexander G Steele; Kris Hoffman; Matthew K Hogan; Allison Frazier; Xiufeng Tang; Dimitry G Sayenko; Philip J Horner

doi:10.3389/fneur.2024.1422357

A novel minimally invasive and versatile kyphoplasty balloon-based model of porcine spinal cord injury

Front Neurol. 2024 Jul 16:15:1422357. doi: 10.3389/fneur.2024.1422357. eCollection 2024.

Authors

Affiliations

¹ Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, TX, United States.
² Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, United States.
³ University of Arkansas for Medical Sciences, Psychiatric Research Institute, Brain Imaging Research Center, Little Rock, AR, United States.

Abstract

Introduction: Spinal cord injury (SCI) animal models often utilize an open surgical laminectomy, which results in animal morbidity and also leads to changes in spinal canal diameter, spinal cord perfusion, cerebrospinal fluid flow dynamics, and spinal stability which may confound SCI research. Moreover, the use of open surgical laminectomy for injury creation lacks realism when considering human SCI scenarios.

Methods: We developed a novel, image-guided, minimally invasive, large animal model of SCI which utilizes a kyphoplasty balloon inserted into the epidural space via an interlaminar approach without the need for open surgery.

Results: The model was validated in 5 Yucatán pigs with imaging, neurofunctional, histologic, and electrophysiologic findings consistent with a mild compression injury.

Discussion: Few large animal models exist that have the potential to reproduce the mechanisms of spinal cord injury (SCI) commonly seen in humans, which in turn limits the relevance and applicability of SCI translational research. SCI research relies heavily on animal models, which typically involve an open surgical, dorsal laminectomy which is inherently invasive and may have untoward consequences on animal morbidity and spinal physiology that limit translational impact. We developed a minimally invasive, large animal model of spinal cord injury which utilizes a kyphoplasty balloon inserted percutaneously into the spinal epidural space. Balloon inflation results in a targeted, compressive spinal cord injury with histological and electrophysiological features directly relevant to human spinal cord injury cases without the need for invasive surgery. Balloon inflation pressure, length of time that balloon remains inflated, and speed of inflation may be modified to achieve variations in injury severity and subtype.

Keywords: animal model; kyphoplasty; minimally invasive surgery; spinal cord contusion injury; spinal cord injury.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was in part supported by the National Institutes of Health (NIH) 1R01NS119587-01A grant, the Walter Neurological Restoration Initiative sponsored by The Paula and J. C. “Rusty” Walter III and the Walter Oil & Gas Corporation, and the Wings for Life Foundation (268). The funders were not involved in the design of the study, the collection, analysis, and interpretation of the experimental data, the writing of this article, or the decision to submit this article for publication.