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Multi-Site Optical Monitoring of Spinal Cord Ischemia during Spine Distraction.
Journal of Neurotrauma ( IF 3.9 ) Pub Date : 2020-08-27 , DOI: 10.1089/neu.2020.7012
David R Busch 1, 2 , Wei Lin 3 , Chunyu Cai 4 , Alissa Cutrone 5 , Jakub Tatka 6 , Brandon J Kovarovic 3 , Arjun G Yodh 7 , Thomas F Floyd 1, 8, 9 , James Barsi 10
Affiliation  

Optimal surgical management of spine trauma will restore blood flow to the ischemic spinal cord. However, spine stabilization may also further exacerbate injury by inducing ischemia. Current electrophysiological technology is not capable of detecting acute changes in spinal cord blood flow or localizing ischemia. Further, alerts are delayed and unreliable. We developed an epidural optical device capable of directly measuring and immediately detecting changes in spinal cord blood flow using diffuse correlation spectroscopy (DCS). Herein we test the hypothesis that our device can continuously monitor blood flow during spine distraction. Additionally, we demonstrate the ability of our device to monitor multiple sites along the spinal cord and axially resolve changes in spinal cord blood flow. DCS-measured blood flow in the spinal cord was monitored at up to three spatial locations (cranial to, at, and caudal to the distraction site) during surgical distraction in a sheep model. Distraction was halted at 50% of baseline blood flow at the distraction site. We were able to monitor blood flow with DCS in multiple regions of the spinal cord simultaneously at ∼1 Hz. The distraction site had a greater decrement in flow than sites cranial to the injury (median −40 vs. −7%,). This pilot study demonstrated high temporal resolution and the capacity to axially resolve changes in spinal cord blood flow at and remote from the site of distraction. These early results suggest that this technology may assist in the surgical management of spine trauma and in corrective surgery of the spine.

中文翻译:

脊柱牵引过程中脊髓缺血的多点光学监测。

脊柱创伤的最佳手术治疗将恢复血液流向缺血的脊髓。然而,脊柱稳定也可能通过诱导缺血进一步加剧损伤。目前的电生理技术无法检测脊髓血流的急性变化或局部缺血。此外,警报会延迟且不可靠。我们开发了一种硬膜外光学设备,能够使用漫反射相关光谱 (DCS) 直接测量和立即检测脊髓血流的变化。在这里,我们测试了我们的设备可以在脊柱牵引期间连续监测血流的假设。此外,我们还展示了我们的设备能够沿脊髓监测多个部位并轴向解决脊髓血流变化的能力。在绵羊模型的手术牵引过程中,DCS 测量的脊髓血流在多达三个空间位置(牵引部位的头部、牵引部位和牵引部位的尾部)进行监测。在牵引部位的基线血流量达到 50% 时停止牵引。我们能够在 ~1 Hz 下同时监测脊髓多个区域的 DCS 血流。分心部位的血流量比受伤部位的颅骨部位有更大的减少(中位数 -40 对 -7%)。这项试点研究证明了高时间分辨率和轴向解决分心部位和远离分心部位的脊髓血流变化的能力。这些早期结果表明,这项技术可能有助于脊柱创伤的外科治疗和脊柱矫正手术。和尾部到分心部位)在绵羊模型的手术分心过程中。在牵引部位的基线血流量达到 50% 时停止牵引。我们能够在 ~1 Hz 下同时监测脊髓多个区域的 DCS 血流。分心部位的血流量比受伤部位的颅骨部位有更大的减少(中位数 -40 对 -7%)。这项试点研究证明了高时间分辨率和轴向解决分心部位和远离分心部位的脊髓血流变化的能力。这些早期结果表明,这项技术可能有助于脊柱创伤的外科治疗和脊柱矫正手术。和尾部到分心部位)在绵羊模型的手术分心过程中。在牵引部位的基线血流量达到 50% 时停止牵引。我们能够在 ~1 Hz 下同时监测脊髓多个区域的 DCS 血流。分心部位的血流量比受伤部位的颅骨部位有更大的减少(中位数 -40 对 -7%)。这项试点研究证明了高时间分辨率和轴向解决分心部位和远离分心部位的脊髓血流变化的能力。这些早期结果表明,这项技术可能有助于脊柱创伤的外科治疗和脊柱矫正手术。我们能够在 ~1 Hz 下同时监测脊髓多个区域的 DCS 血流。分心部位的血流量比受伤部位的颅骨部位有更大的减少(中位数 -40 对 -7%)。这项试点研究证明了高时间分辨率和轴向解决分心部位和远离分心部位的脊髓血流变化的能力。这些早期结果表明,这项技术可能有助于脊柱创伤的外科治疗和脊柱矫正手术。我们能够在 ~1 Hz 下同时监测脊髓多个区域的 DCS 血流。分心部位的血流量比受伤部位的颅骨部位有更大的减少(中位数 -40 对 -7%)。这项试点研究证明了高时间分辨率和轴向解决分心部位和远离分心部位的脊髓血流变化的能力。这些早期结果表明,这项技术可能有助于脊柱创伤的外科治疗和脊柱矫正手术。这项试点研究证明了高时间分辨率和轴向解决分心部位和远离分心部位的脊髓血流变化的能力。这些早期结果表明,这项技术可能有助于脊柱创伤的外科治疗和脊柱矫正手术。这项试点研究证明了高时间分辨率和轴向解决分心部位和远离分心部位的脊髓血流变化的能力。这些早期结果表明,这项技术可能有助于脊柱创伤的外科治疗和脊柱矫正手术。
更新日期:2020-09-12
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