Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring

David R. Busch, Wei Lin, Chia Chieh Goh, Feng Gao, Nicholas Larson, Joseph Wahl, Thomas V. Bilfinger, Arjun G. Yodh, Thomas F. Floyd

Research output: Contribution to journalArticlepeer-review

Abstract

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%. This monitor demonstrated 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.

Original languageEnglish (US)
Article numbere0251271
JournalPloS one
Volume16
Issue number5 May 2021
DOIs
StatePublished - May 2021

ASJC Scopus subject areas

  • General

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