Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model

<b>Introduction</b>: Intradural extramedullary and intramedullary spinal tumors are rare, complex to treat, and require advanced surgical techniques. Ultrasonic aspirators, commonly used for tumor removal, can cause sensory and motor deficits, including loss of motor evoked potentials (M...

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Main Authors: Mauro Palmieri, Alessandro Pesce, Mattia Capobianco, Massimo Corsini, Giorgia Iovannitti, Fulvio Aloj, Giuseppa Zancana, Vincenzo Esposito, Maurizio Salvati, Antonio Santoro, Gianpaolo Cantore, Alessandro Frati
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Language:English
Published: MDPI AG 2025-06-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/7/670
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author Mauro Palmieri
Alessandro Pesce
Mattia Capobianco
Massimo Corsini
Giorgia Iovannitti
Fulvio Aloj
Giuseppa Zancana
Vincenzo Esposito
Maurizio Salvati
Antonio Santoro
Gianpaolo Cantore
Alessandro Frati
author_facet Mauro Palmieri
Alessandro Pesce
Mattia Capobianco
Massimo Corsini
Giorgia Iovannitti
Fulvio Aloj
Giuseppa Zancana
Vincenzo Esposito
Maurizio Salvati
Antonio Santoro
Gianpaolo Cantore
Alessandro Frati
author_sort Mauro Palmieri
collection DOAJ
description <b>Introduction</b>: Intradural extramedullary and intramedullary spinal tumors are rare, complex to treat, and require advanced surgical techniques. Ultrasonic aspirators, commonly used for tumor removal, can cause sensory and motor deficits, including loss of motor evoked potentials (MEPs). This study aims to evaluate the safety and efficacy of ultrasonic aspirators in intramedullary tumor surgery using a swine model, comparing different systems and techniques. <b>Methods</b>: Ten pigs underwent D1-D3 laminectomy and myelotomy, with adipose tissue simulating a tumor. The ultrasonic aspirators were tested under varying conditions (fragmentation power, suction, application time, and vibration mode). The primary endpoint is to evaluate the impact of the chosen variables on motor function damage. The secondary endpoints are histological evaluation of the type of damage caused by ultrasound aspirators and the effect of steroid drugs on MEPs’ impairment recovery. <b>Results</b>: Ultrasound aspirators can cause a significant MEP signal reduction when used in continuous mode, with fragmentation power >30 for more than 2 min (<i>p</i> < 0.001). Suction does not affect MEPs. When used in alternating/pulsatile mode, fragmentation power and application time do not affect MEPs. The two-way ANOVA analysis on the interaction between fragmentation power and application time in continuous mode did not demonstrate a significant interaction (<i>p</i> = 0.155). Time alone does not affect motor damage (<i>p</i> = 0.873). Betamethasone can restore MEPs’ signal after damage if administered immediately. <b>Conclusions</b>: Using ultrasonic aspirators in an animal model of intramedullary tumor surgery is safe. The main factor that resulted in the responsibility of motor function impairment is the fragmentation power.
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spelling doaj-art-cf4b8ca904af4fc6a675f89c293f34002025-08-20T03:32:24ZengMDPI AGBrain Sciences2076-34252025-06-0115767010.3390/brainsci15070670Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine ModelMauro Palmieri0Alessandro Pesce1Mattia Capobianco2Massimo Corsini3Giorgia Iovannitti4Fulvio Aloj5Giuseppa Zancana6Vincenzo Esposito7Maurizio Salvati8Antonio Santoro9Gianpaolo Cantore10Alessandro Frati11Human Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, ItalyDepartment of Neurosurgery, University of Rome ‘’Tor Vergata”, 00133 Rome, ItalyHuman Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, ItalyHuman Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, ItalyHuman Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, ItalyIRCCS “Neuromed”, 86077 Pozzilli, ItalyHuman Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, ItalyIRCCS “Neuromed”, 86077 Pozzilli, ItalyDepartment of Neurosurgery, University of Rome ‘’Tor Vergata”, 00133 Rome, ItalyHuman Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, ItalyHuman Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, ItalyHuman Neurosciences Department, Neurosurgery Division, “Sapienza” University, 00161 Rome, Italy<b>Introduction</b>: Intradural extramedullary and intramedullary spinal tumors are rare, complex to treat, and require advanced surgical techniques. Ultrasonic aspirators, commonly used for tumor removal, can cause sensory and motor deficits, including loss of motor evoked potentials (MEPs). This study aims to evaluate the safety and efficacy of ultrasonic aspirators in intramedullary tumor surgery using a swine model, comparing different systems and techniques. <b>Methods</b>: Ten pigs underwent D1-D3 laminectomy and myelotomy, with adipose tissue simulating a tumor. The ultrasonic aspirators were tested under varying conditions (fragmentation power, suction, application time, and vibration mode). The primary endpoint is to evaluate the impact of the chosen variables on motor function damage. The secondary endpoints are histological evaluation of the type of damage caused by ultrasound aspirators and the effect of steroid drugs on MEPs’ impairment recovery. <b>Results</b>: Ultrasound aspirators can cause a significant MEP signal reduction when used in continuous mode, with fragmentation power >30 for more than 2 min (<i>p</i> < 0.001). Suction does not affect MEPs. When used in alternating/pulsatile mode, fragmentation power and application time do not affect MEPs. The two-way ANOVA analysis on the interaction between fragmentation power and application time in continuous mode did not demonstrate a significant interaction (<i>p</i> = 0.155). Time alone does not affect motor damage (<i>p</i> = 0.873). Betamethasone can restore MEPs’ signal after damage if administered immediately. <b>Conclusions</b>: Using ultrasonic aspirators in an animal model of intramedullary tumor surgery is safe. The main factor that resulted in the responsibility of motor function impairment is the fragmentation power.https://www.mdpi.com/2076-3425/15/7/670ultrasound aspiratorCNS tumorsspinal cordintramedullary tumorsanimal model
spellingShingle Mauro Palmieri
Alessandro Pesce
Mattia Capobianco
Massimo Corsini
Giorgia Iovannitti
Fulvio Aloj
Giuseppa Zancana
Vincenzo Esposito
Maurizio Salvati
Antonio Santoro
Gianpaolo Cantore
Alessandro Frati
Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model
Brain Sciences
ultrasound aspirator
CNS tumors
spinal cord
intramedullary tumors
animal model
title Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model
title_full Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model
title_fullStr Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model
title_full_unstemmed Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model
title_short Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model
title_sort safety and efficacy evaluation of ultrasound aspirators in intramedullary spinal cord tumors surgery an experimental study on a swine model
topic ultrasound aspirator
CNS tumors
spinal cord
intramedullary tumors
animal model
url https://www.mdpi.com/2076-3425/15/7/670
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