Spinal Fiber Optic Monitoring

 描述(由申请人提供)：脊髓缺血导致主要血管、脊柱和脊髓手术以及脊柱创伤后改变生活的瘫痪和瘫痪。目前用于检测脊髓缺血的方法是基于电生理学的，监测缺血对电信号传递的影响。这些信号的降解需要离子梯度失效，细胞死亡开始。海流 因此，技术是间接的和暂时的延迟。它还被证明缺乏所需的特异性和可靠性，以避免瘫痪或瘫痪等毁灭性后果。我们开发了一种基于漫反射相关光谱(DCS)和漫反射光谱(DOS)原理的原型光纤设备，可以快速检测和连续监测脊髓血流量和氧合的变化。这一新的设备是神经生理学监测向前迈出的重要一步，为术中检测脊髓缺血和在神经危重护理环境中提供了新的准确性和即时性。有朝一日，这种设备可能会使麻醉师、神经强化医生、急救人员和护理人员能够对脊髓缺血进行持续的、床边的、用户友好的监测。具体目标：目的1)设计和制造第二代多节段脊髓光纤探头，能够在轴向上区分脊髓多个椎体区域的缺血障碍。目的2)继续开发和优化用于脊髓血流量和氧合监测的光纤实时监测平台。目的3)对第二代多水平探头和PXI-Platform实时监护仪进行初步台架和临床前测试。目的4)设计和生产一种紧凑、便携、用户友好、可在床边使用的DCS/DOS监护仪。目的5)完成第二代探头和监护仪的台架和临床前测试。

 DESCRIPTION (provided by applicant): Spinal cord ischemia results in life-changing paralysis and paraparesis after major vascular, spine and spinal cord surgery, and spine trauma. Methods currently employed to detect spinal cord ischemia are based upon electrophysiology, monitoring the effect of ischemia upon electrical signal transmission. Degradation of these signals requires ionic gradients to fail, and cell death to begin. The current technology is therefore indirect and temporally delayed. It has also been proven to lack the specificity and reliability desired to avert such a devastating consequence as paralysis or paraparesis. We have developed a prototypical fiber optic device, based on Diffuse Correlation Spectroscopy (DCS) and Diffuse Optical Spectroscopy (DOS) principles, that permits rapid detection and continuous monitoring of changes in spinal cord blood flow and oxygenation. This novel device is an important step forward for neurophysiological monitoring, offering a new level of accuracy and immediacy for intraoperative detection of spinal cord ischemia and in the neurocritical care setting. This device may one day enable continuous, bedside, user friendly monitoring for spinal cord ischemia by anesthesiologists, neurointensivists, emergency, and nursing personnel. Specific Aims: Aim 1) To design and produce a second generation multi-level spinal cord fiber-optic probe, capable of axially discriminating ischemic disturbances across multiple vertebral regions in the spinal cord. Aim 2) To continue to develop and optimize a real-time fiber optic monitoring platform for the monitoring of spinal cord blood flow and oxygenation. Aim 3) To conduct preliminary bench and pre-clinical testing of the second generation multi- level probes and PXI-platform real-time monitor. Aim 4) To design and produce a compact, portable, user friendly, DCS/DOS monitor, capable of being used at the bedside. Aim 5) To complete bench and pre-clinical testing of the second generation probes and monitor.