OCT-Guided Interventions for Pain Management

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DESCRIPTION (provided by applicant): The spinal epidural space is a poorly accessible site within the bony spinal canal where therapeutic interventions that affect millions of Americans are carried out each year. Examples include epidural anesthesia and management of low back pain. Between two and three million epidurals are performed each year in this country for obstetrical analgesia. A comparable number of epidural anesthesia procedures are performed as part of other surgical indications. Low back pain has been estimated to exact >$50 billion a year burden on the American economy. The pathology typically lies within or immediately adjacent to the epidural space. Existing clinical imaging technology is unable to provide the spatial resolution or the realtime capabilities needed for therapeutic interventions within this space. There is a great unfilled need to be able to clearly image in real-time structures such as individual nerve roots, blood vessels, dura, free disc fragments, and fibrous scar tissue within and adjacent to the spinal epidural space. Optical coherence tomography (OCT) is an emerging technology that is ideally and uniquely suited for imaging within the spinal canal. The first goal of this project is to modifiy and adapt catheter-based OCT technology for applications in the spine. The second goal is to determine the feasibility and advantages of OCT-guided interventions for acute and chronic pain management. This will be a collaborative effort between an academic medical center and the industry leader in catheter-based OCT technology.