Brain & spine · 2026
Spinal cord protection by epidural separation during vertebral cryoablation for metastatic spine disease: A proof-of-concept preclinical study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Uto Takaaki, Kato Satoshi, Yokogawa Noriaki, Shimizu Takaki, Kobayashi Motoya, Nagatani Satoshi, Kawai Masafumi, Ishino Yuji, Nanpo Kazuhiro, Kawai Megumu, Demura Satoru
Аннотация
INTRODUCTION: Cryoablation for spinal metastases is limited by the risk of cryogenic neural injury near the spinal cord. Physical separation between the vertebral body and dura may provide a thermal margin, but the distance-temperature relationship in the epidural space remains insufficiently defined.
RESEARCH QUESTION: This exploratory study aimed to map the association between surgically created epidural separation distance and local thermal and neurophysiological changes during vertebral cryoablation in a canine model.
MATERIAL AND METHODS: In a non-randomized, unblinded, two-phase pilot study, we first performed in vitro phantom experiments (0-, 2-, and 5-mm air gaps). Subsequently, 12 beagle dogs were assigned to three groups (n = 4 each): 0-mm (control), 2-mm, or 5-mm epidural separation, followed by T13 vertebral cryoablation. Primary outcomes were the minimum epidural temperature at the ventral midline and 30-min compound muscle action potential (CMAP) amplitude recovery.
RESULTS: In vitro, greater separation distance was associated with significantly warmer target-point temperatures (P < .001). In vivo, a 5-mm separation produced warmer ventral midline epidural temperatures, which remained above a previously reported safety estimate of 4 °C, and greater CMAP recovery compared to a 2-mm separation (P = .024 and P = .028, respectively).
DISCUSSION AND CONCLUSION: In this proof-of-concept canine study, epidural separation distance was associated with ventral epidural temperature and short-term CMAP recovery during vertebral cryoablation. These findings do not establish a clinical safety threshold and require validation in clinically relevant models, including studies with survival and histologic assessment.
RESEARCH QUESTION: This exploratory study aimed to map the association between surgically created epidural separation distance and local thermal and neurophysiological changes during vertebral cryoablation in a canine model.
MATERIAL AND METHODS: In a non-randomized, unblinded, two-phase pilot study, we first performed in vitro phantom experiments (0-, 2-, and 5-mm air gaps). Subsequently, 12 beagle dogs were assigned to three groups (n = 4 each): 0-mm (control), 2-mm, or 5-mm epidural separation, followed by T13 vertebral cryoablation. Primary outcomes were the minimum epidural temperature at the ventral midline and 30-min compound muscle action potential (CMAP) amplitude recovery.
RESULTS: In vitro, greater separation distance was associated with significantly warmer target-point temperatures (P < .001). In vivo, a 5-mm separation produced warmer ventral midline epidural temperatures, which remained above a previously reported safety estimate of 4 °C, and greater CMAP recovery compared to a 2-mm separation (P = .024 and P = .028, respectively).
DISCUSSION AND CONCLUSION: In this proof-of-concept canine study, epidural separation distance was associated with ventral epidural temperature and short-term CMAP recovery during vertebral cryoablation. These findings do not establish a clinical safety threshold and require validation in clinically relevant models, including studies with survival and histologic assessment.