• Chih-Hong Yang, Yueh-Feng Chiang, Chia-Hsien Chen, Lien-Chen Wu, Chun-Jen Liao, and Chang-Jung Chiang.
• Department of Orthopaedics, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.
• Eur Spine J. 2016 Mar 1; 25 (3): 906-12.

PurposeThe purpose was to quantify the structural integrity of annulus fibrosis (AF) after injuries with repair.MethodsPunctures in the AF of 6-month-old porcine spine specimens were made with 18-, 20-, 22-, 24-, and 26-gauge needles. Leakage testing was performed immediately after needle puncture (Group 1), after the puncture was repaired with a modified purse-string suture (MPSS) (Group 2), and after needle puncture with immediate repair (Group 3). Punch injuries repaired with the MPSS alone, or with an AF graft and MPSS were also examined.ResultsThere was no leakage from 26-gauge needle punctures. Pressures at which the nucleus pulposus leaked from the 24-, 22-, 20- and 18-gauge needle punctures (Group 1) were 4.28, 2.03, 1.27, and 1.06 MPa, respectively. Failure pressure after repair (Group 2, 3) was significantly greater than without (Group 1). Failure pressure in Group 3 was much greater than in Group 2 with 18- and 20-gauge punctures. Punch injury repaired with a graft and MPSS had significantly greater failure pressure than repair with MPSS alone (1.88 vs. 1.02 MPa, p = 0.0001).ConclusionsThe MPSS can restore the mechanical integrity of the AF after needle puncture. An annular graft along with a MPSS may increase the structural integrity of the AF after a punch injury. As this was an acute animal study, the measurements and results may not directly translate to the human intervertebral disc.

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