Cadaveric Porcine Spines as a Model for the Human Epidural Space.

Abstract

Most patients who undergo epidural anesthesia are pregnant and thus a protected population, which has limited investigations of the human epidural space. Among the several species studied as models for the human spine, the porcine spine has been used as a model for spine instrumentation. Although the spread of colored dye within the porcine epidural space has been investigated, no model has demonstrated in situ spread by using radiopaque contrast dye. To this end, we here used 10 Yorkshire swine cadavers through an approved tissue sharing agreement. Epidural catheters were placed by using a landmark-based loss-of-resistance technique; placement was confirmed through radiography. The catheters were connected to epidural infusion pumps to ensure consistent dosing, 2-mL boluses of contrast dye were injected into the space, and radiographs were taken and recorded after each bolus. The total spread of the contrast dye was analyzed. We demonstrated consistent and reliable spread of fluid in the epidural space among the animals used, with low variability between animals of different weights. Our results support the use of the epidural space of cadaveric swine as a model for the human epidural space. Furthermore, the technique for epidural administration by using the landmark-based loss-of-resistance demonstrated in this model was validated, thus supporting future investigations of medication delivery into the epidural space.