Spinal cord ischemia leads to iatrogenic injury in multiple surgical fields, and the ability to immediately identify onset and anatomic origin of ischemia is critical to its management. Current clinical monitoring, however, does not directly measure spinal cord blood flow, resulting in poor sensitivity/specificity, delayed alerts, and delayed intervention. We have developed an epidural device employing diffuse correlation spectroscopy (DCS) to monitor spinal cord ischemia continuously at multiple positions. We investigate the ability of this device to localize spinal cord ischemia in a porcine model and validate DCS versus Laser Doppler Flowmetry (LDF). Specifically, we demonstrate continuous (>0.1Hz) spatially resolved (3 locations) monitoring of spinal cord blood flow in a purely ischemic model with an epidural DCS probe. Changes in blood flow measured by DCS and LDF were highly correlated (r=0.83). Spinal cord blood flow measured by DCS caudal to aortic occlusion decreased 62%, with a sensitivity of 0.87 and specificity of 0.91 for detection of a 25% decrease in flow. This technology may enable early identification and critically important localization of spinal cord ischemia.

中文翻译：

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使用微创多级硬膜外探头对脊髓血流进行空间分辨光学监测

脊髓缺血会在多个外科领域导致医源性损伤，因此立即识别缺血的发作和解剖起源的能力对其管理至关重要。然而，当前的临床监测不能直接测量脊髓的血流，从而导致敏感性/特异性差，警报延迟和干预延迟。我们已经开发了一种采用弥散相关光谱法（DCS）的硬膜外装置来连续监测多个部位的脊髓缺血。我们研究了该设备在猪模型中定位局部缺血的能力，并验证了DCS与激光多普勒血流仪（LDF）的对比。具体来说，我们展示了硬膜外DCS探针在纯缺血模型中连续（> 0.1Hz）的空间分辨（3个位置）的脊髓血流监测。DCS和LDF测量的血流变化高度相关（r = 0.83）。通过DCS尾部测量到主动脉闭塞的脊髓血流量减少了62％，灵敏度为0.87，检测血流减少25％的特异性为0.91。这项技术可以使脊髓缺血的早期识别和至关重要的局部化成为可能。