Improving Spinal Growth Modulation using a Novel Kyphotic Porcine Model

使用新型猪后凸模型改善脊柱生长调节

• 批准号: 10303876
• 负责人: Thomas D Crenshaw
• 金额: $ 21.51万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-05 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10303876
• 关键词: Acceleration; Adult; Affect; Animal Model; Animals; Apical; Behavior; Biomechanics; Bone Growth; Child; Child Care; Childhood; Clinical; Clinical Research; Collection; Data; Deformity; Devices; Effectiveness; Excision; Goals; Growth; Growth Factor; Human; Intervertebral disc structure; Lead; Literature; Measures; Modeling; Motion; Operative Surgical Procedures; Patients; Play; Procedures; Reporting; Risk; Role; Spinal; Spinal Curvatures; Spinal Fusion; Surgeon; Techniques; Testing; Time; Translating; Vertebral column; Weight-Bearing state; Work; base; care costs; clinical translation; dietary manipulation; effectiveness study; experience; flexibility; improved; instrument; long bone; mathematical model; new growth; novel; porcine model; pressure; response; spine bone structure; standard of care; success; vertebra body

Title: Improving Spinal Growth Modulation using a Novel Kyphotic Porcine Model PROJECT SUMMARY Spinal fusion is the current standard of care for the treatment of pediatric spinal deformities. However, this technique ignores the child’s growth potential and eliminates all growth and motion through the deformed regions of the spine. Recently, attempts to harness the growth potential of the immature spine using flexible vertebral tethers to correct spinal curvatures have been promising; however, the effectiveness of these techniques appears limited to small deformities in younger patients. In this work, we propose to use a novel kyphotic porcine model to (1) determine if straight and deformed spines respond differently to tether tension, (2) measure the effects that different tether tensions have on growth in the deformed spine, and (3) compare the rates of deformity correction using tethers with and without vertebral periosteal resection. While current spinal growth modulation strategies have relied on deformity correction through convex growth inhibition alone, we will combine growth acceleration in the concavity with convex growth inhibition, to increase the magnitude of deformity correction possible using these non-fusion techniques. At the conclusion of this study, the differences in the effects that varying tether tensions have on normal and deformed spines in terms of disc behavior and longitudinal vertebral growth rates will be determined. We anticipate that increasing tether tension will cause an immediate change in vertebral alignment but will inadvertently inhibit the differential growth necessary for long lasting deformity correction. Conversely, we expect periosteal resection to accelerate overall vertebral growth and therefore increase the effectiveness of the standard tethering. As this work will be performed in our novel large animal model, these data can be readily translated to improve current clinical spinal growth modulation strategies and make this model a platform on which to develop and refine new growth modulating devices.

标题：使用新型脊柱后凸猪模型改善脊柱生长调节 项目摘要 脊柱融合术是目前治疗小儿脊柱畸形的标准治疗方法。但这 这种技术忽略了孩子的生长潜力，通过畸形的身体消除了所有的生长和运动。 脊柱的区域。最近，尝试利用未成熟脊柱的生长潜力， 脊椎栓系矫正脊柱弯曲是有希望的;然而， 技术似乎仅限于年轻患者的小畸形。在这项工作中，我们建议使用一本小说 脊柱后凸猪模型，以（1）确定直的和变形的脊柱是否对系绳张力有不同的反应， (2)测量不同系绳张力对变形脊柱生长的影响，以及（3）比较 采用栓系结合和不结合椎体骨膜切除的畸形矫正率。虽然目前的 脊柱生长调节策略依赖于仅通过抑制凸起生长的畸形矫正， 我们将联合收割机结合凸起生长抑制和生长加速， 使用这些非融合技术的可能性。在这项研究结束时， 不同的系绳张力对正常和变形脊柱椎间盘影响的差异 将确定行为和纵向椎骨生长速率。我们预计， 张力将导致椎骨排列的立即改变，但会无意中抑制差异 长期畸形矫正所需的生长。相反，我们希望骨膜切除术 加速整个椎骨的生长，从而提高标准栓系的有效性。因为这 工作将在我们的新的大型动物模型中进行，这些数据可以很容易地转化为改善当前的 临床脊柱生长调节策略，并使该模型成为开发和完善的平台 新的生长调节装置。