To assess the accuracy of transsphenoidal hypophysectomy using 3-D printed patient-specific guides (3D-PSGs) in small-breed dogs.
Heads obtained from the cadavers of 19 small-breed dogs (ex vivo portion of study) and 3 healthy adult (3 to 4 years) purpose-bred Beagles with a median body weight of 9.2 kg.
In the ex vivo study, CT images of the cadavers were collected. The position, width, and length of the pituitary fossa and the pilot hole (insertion angle and place) were measured. Using PSGs, 19 pilot holes were made for the pituitary gland fossa, and CT was performed to assess the position accuracy. In the in vivo study, 3 surgical windows from the pilot holes were made using PSGs. Repeated CT and MRI were performed to evaluate the safeness and effectiveness of PSGs, followed by necropsy.
In the ex vivo study, the median (interquartile range) difference between the pre- and postoperative insertion angles was 2° (0° to 3.5°) and the median deviation of the pilot hole was 0.46 mm (0 to 1.58 mm). In the in vivo study, the surrounding structures were not damaged, and favorable outcomes were evident in terms of the shape, size, and position of the surgical window.
3D-PSGs provided a safe and effective surgical window for transsphenoidal hypophysectomy. Our findings emphasized the applicability of PSGs in brain surgery, in terms of accuracy and effectiveness.
To describe a novel transforaminal approach for surgical excision of the atlantoaxial (AA) band and examine its feasibility, safety, and mechanical advantages in an ex vivo study and clinical cases.
26 canine cadavers and 2 canine patients with AA bands.
The transforaminal approach via the first intervertebral foramen was designed to avoid damaging the dorsal AA ligament (DAAL) and dorsal laminas to maintain joint stability. The cadaveric study started on December 2020 and lasted 3 months. The ligamentum flavum (LF) was removed using a novel approach; then, gross examination was conducted to verify the potential damage to the spinal cord and associated structures and the adequacy of LF removal. Subsequently, the ex vivo tension test of the DAAL was conducted to establish whether the approach induced mechanical damage to the ligaments. Finally, 2 dogs diagnosed with an AA band were surgically treated with the transforaminal approach.
In the cadaveric study, postsurgical evaluation verified the subtotal removal of LF without damage to the dura mater. There were no significant differences in the mechanical properties of the DAAL, including the ultimate strength (P = .645) and displacement (P = .855), between the surgical and intact groups during the ex vivo tension test. In clinical cases, clinical signs and neurologic grades improved until the final follow-up.
The described surgical procedure using a transforaminal approach appears to sufficiently permit the removal of an AA band while reducing damage to the DAAL and spinal cord. Our study highlights the feasibility of the transforaminal approach.
Objective—To establish the dose-dependent effects of high-molecular-weight hyaluronic acid (HA) supplementation on chondrogenesis by mesenchymal stem cells (MSCs) cultured on chitosan sponges and to determine the extent to which MSC matrix production (chondrogenesis) can be influenced by incorporation of high-molecular-weight HA into chitosan scaffolds.
Sample Population—Murine MSCs derived from a multipotent bone marrow stromal precursor.
Procedures—MSCs were seeded on chitosan and chitosan-HA scaffolds in chondrogenic medium with various HA concentrations. Scanning electron microscopy, fluorescence microscopy (viability assay), and DNA quantification were used to assess cell attachment, distribution, and viability 48 hours after seeding. Constructs were cultured for 3 weeks prior to evaluation of cell distribution and chondrogenic differentiation via histologic evaluation and quantification of DNA, glycosaminoglycan, and collagen II.
Results—48 hours after MSC seeding, cell viability and DNA content were similar among groups. Three weeks after seeding, HA supplementation of the culture medium improved matrix production in a dose-dependent manner, as indicated by matrix glycosaminoglycan and collagen II concentrations. The scaffold composition, however, had no significant effect on matrix production.
Conclusions and Clinical Relevance—High-molecular-weight HA supplementation in culture medium had a dose-dependent effect on matrix production and thus chondrogenic differentiation of MSCs cultured on chitosan sponges. The addition of HA in the surrounding fluid during chondrogenesis should improve cartilage production and may be useful for producing engineered cartilage tissues.