Balloon Compression Spinal Cord Injury in Animal Model Using Canine and Capra
Purpose: This study aims to observe the feasibility of canines and capra as large animal models for the use in SCI in vivo research. Components observed in this study include daily activity, and neurological function. Methods: This research incorporated the use of goats (Capra aegagrus hircus) and dogs (Canis lupus familiaris) as the animal model of choice due to similarities in spine and vertebral structures with humans. To stimulate SCI in animals, ballooning compression was done in animals to mimic the compression-stimulated SCI common in human. Results: The induction procedure was successfully done in all animals. Directly following the induction procedure, motoric and sensory functions were absent in all dogs and goats. Decreased physical activity was observed in goats. Compromised urinary function was observed in both goats and dogs. Both animals retained defecation function. Inflammation, hemorrhaging, and necrosis was observed in histopathological investigations. Conclusion: In our observations, the dog animal model was found to be more suitable for the use in SCI studies. The dog animal model was found to give more consistent findings, easier observations, and similar neurological and histopathological findings as that of SCI in humans.
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In this research, all animals were marked at the lumbar vertebrae L1 level for the initial incision. To reach the level of T10–T11 – the compression target – the balloon inserted approximately 5 cm from L1 based on radiological measurement findings. To stimulate SCI in animals, ballooning compression was done in animals to mimic the compression-stimulated SCI since this mechanism is common in human. The animals were anesthetized using ketamine 10 mg/kg and sedation was maintained during surgery using sevoflurane 1–2% per inhalation route. An endotracheal tube was inserted to maintain respiratory function during the surgery. A urinary catheter was placed for the observation the loss of urinary function post-procedure. Initially, an incision was made at the back of the animal by the surgical operator to have a view of the vertebral lamina from the L1 segment. Decompression was done using a 1 mm curve curette, to release the flavum ligament. Laminotomy procedure was then done in the lower lamina and upper lamina of the targeted interlaminar space using a 1 mm and 2 mm Kerrison rongeur to clear the area for entrance of the Fogarty’s catheter (FC). Subsequently, FC was then inserted through the opening of the perforated lamina and placed in the epidural space. From there, the balloon was inserted cranially approximately 5 cm to the level of the T10–T11 segment of the spinal cord. At this level, the balloon was inflated with 1.0 mL of iohexol contrast agent until the epidural space was filled. Extra care was done to ensure no air was present within the inflated balloon. An involuntary jerk reaction is observed at this stage which was used as an indication of induced paralysis. After the balloon insertion, the surgical site was closed by suturing. A drain was placed under the fascia to drain excess blood or discharge within surgical area The catheter was sealed to prevent leakage and the balloon was left inflated for 6 hours post-surgery. Post operative X-ray examinations were carried out to confirm proper position of the balloon at the level of T10–T11, as well as the occlusion of the spinal canal. Six hours after the procedure, X-ray imaging was repeated to confirm the condition of the inserted balloon. Whether it remained inflated or not. After confirmation, the balloon was then deflated and removed gently from the epidural space without disrupting the previous surgical suture.
Ministry of Education, Culture, Research and Technology by National Research and Innovation agency of Indonesia