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Establishing a through-puncture model for assessing post-injection leakage in the intervertebral disc
Lara J Varden1, Evan J Turner2, Allison T Coon2
1Department of Biology, Clarkson University, Potsdam, NY, USA.
Summary
Therapeutic agent leakage from intervertebral discs (IVDs) after needle injection is a significant concern. This study quantifies leakage, finding that needle size, axial compression, and flexion critically influence needle track geometry and fluid retention.
Area of Science:
- Biomedical Engineering
- Spinal Research
- Drug Delivery Systems
Background:
- Needle injection into the intervertebral disc (IVD) is a primary route for therapeutic agent delivery.
- Post-injection leakage of these agents is a known complication following needle retraction.
Purpose of the Study:
- To develop a method for quantifying post-injection leakage from the IVD.
- To evaluate how needle track geometry, influenced by needle size, axial load, and flexion, affects leakage.
Main Methods:
- Bovine caudal IVDs underwent a standardized needle puncture and injection procedure.
- Leakage was assessed by varying needle gauge (30G, 26G, 21G), axial compression (0-10% strain), and flexion (15°).
Main Results:
- Smaller needle diameters (30G) allowed for larger injected volumes before leakage compared to larger needles (21G).
- Axial compression significantly reduced leakage incidence (50-100%), while flexion resulted in a 22% leakage rate.
- All unloaded discs experienced leakage.
Conclusions:
- Fluid leakage from the IVD after needle injection is a substantial risk.
- Needle track geometry is a key determinant of leakage, significantly affected by needle size, axial compression, and flexion.
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