Korean J Pain.  2019 Oct;32(4):264-270. 10.3344/kjp.2019.32.4.264.

Quantitative assessment of steroid amount in the tissue after epidural steroid injection: a new rabbit model

• Cho J
• Lee JW
• Lee E
• Kang Y
• Cho HR
• Kim DY
• Ho MJ
• Kang MJ
• Choi YS

• KMID: 2462836
• DOI: http://doi.org/10.3344/kjp.2019.32.4.264

Abstract

BACKGROUND
To develop a rabbit epidural steroid injection (ESI) model for analyzing steroid retention in the tissue, and to assess the difference in steroid retention in the model according to the location and time elapsed after ESI.
METHODS
Fluoroscopy-guided ESI was performed using the interlaminar approach between the lowest two lumbar segments in 13 female New Zealand white rabbits. Four rabbits were allocated to each of three different groups according to the time of sacrifice: 3, 7, and 15 days post-ESI; the remaining rabbit was sacrificed immediately post-ESI to obtain baseline data. After sacrifice, two segments were harvested: the lowest two lumbar vertebrae and another two lumbar vertebrae immediately above these. The residual steroid amount (RSA) and residual steroid concentration (RSC) in the collected spinal columns were analyzed. A linear mixed model was used to compare RSAs and RSCs between the injected and adjacent segments, and among the number of days until sacrifice; P < 0.05 was considered statistically significant.
RESULTS
Both RSA and RSC of the injected segment were significantly higher than those of the adjacent segment (P < 0.001, both). The RSA and RSC significantly decreased over time (P = 0.009 and P = 0.016, respectively).
CONCLUSIONS
The developed rabbit ESI model verified that significantly more steroid was retained at the injected segment than at the adjacent segment and the residual steroid decreased over time. This model could be useful not only for comparing current steroid medications, but also for developing new, better steroid formulations.

Keyword

Fluoroscopy; Injections, Epidural; Lumbar Vertebrae; Models, Animal; Pain; Rabbits; Spine; Steroids

MeSH Terms

Female
Fluoroscopy
Humans
Injections, Epidural
Lumbar Vertebrae
Models, Animal
Rabbits
Spine
Steroids
Steroids

Figure

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  Fig. 1 Flow diagram of the experimental design. ESI: epidural steroid injection.

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  Fig. 2 Epidural injection of triamcinolone through the interlaminar route. (A) Spine anteroposterior radiograph of the prone-positioned rabbit. (B) Interlaminar approach with a 25-gauge spinal Quincke needle. (C) Appropriate needle tip placement confirmed by the injection of a contrast agent.

• 

  Fig. 3 Representative image showing the tissue being harvested. Two dorsal sections of the rabbit corresponding to the lumbar spine were excised en bloc, including the lowest two (level of epidural steroid injection) lumbar vertebrae and the segment immediately above them.

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  Fig. 4 Line graphs of residual steroid measurements in the harvested tissue. (A) Residual steroid amount (RSA). (B) Residual steroid concentration (RSC).

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