OCT-Guided Interventions for Pain Management

描述(由申请人提供)： 脊柱硬膜外间隙是骨性椎管内一个很难到达的地方，每年都会在那里进行影响数百万美国人的治疗干预。例子包括硬膜外麻醉和腰痛的治疗。在这个国家，每年有200万到300万例硬膜外麻醉用于产科止痛。同样数量的硬膜外麻醉手术是作为其他手术适应症的一部分进行的。据估计，腰痛每年给美国经济造成500亿美元的负担。病变通常位于硬膜外间隙内或紧邻硬膜外间隙。现有的临床成像技术不能提供空间分辨率或在这个空间内进行治疗干预所需的实时能力。对于脊柱硬膜外间隙内和邻近的单个神经根、血管、硬脑膜、游离盘碎片和纤维瘢痕组织等实时结构，需要能够清晰地进行实时成像。光学相干层析成像(OCT)是一种新兴的技术，非常适合于椎管内成像。该项目的第一个目标是改进和调整基于导管的OCT技术，使其适用于脊柱。第二个目标是确定OCT引导的介入治疗急慢性疼痛的可行性和优势。这将是学术医学中心与基于导管的OCT技术的行业领先者之间的合作努力。

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.