Spinal Fiber Optic Monitoring

 描述（由申请人提供）：脊髓缺血导致重大血管、脊柱和脊髓手术以及脊柱创伤后改变生命的瘫痪和下肢轻瘫。目前用于检测脊髓缺血的方法是基于电生理学，监测缺血对电信号传输的影响。这些信号的降解需要离子梯度失效，并且细胞死亡开始。当前 因此，技术是间接的和暂时的延迟。它也被证明缺乏所需的特异性和可靠性，以避免瘫痪或轻瘫等毁灭性后果。 我们已经开发了一种原型光纤设备，基于扩散相关光谱（DCS）和扩散光学光谱（DOS）的原则，允许快速检测和连续监测脊髓血流和氧合的变化。这种新型设备是神经生理监测的重要一步，为术中检测脊髓缺血和神经重症监护提供了新的准确性和即时性。该设备可能有一天能够由麻醉师、神经重症监护医师、急诊和护理人员对脊髓缺血进行连续的、床边的、用户友好的监测。具体目标：目的1）设计并制造第二代多节段脊髓光纤探头，能够轴向区分脊髓多个椎体区域的缺血性疾病。目的2）继续开发和优化一种用于脊髓血流和氧合监测的实时光纤监测平台。目的3）对第二代多节段探头和PXI平台实时监测器进行初步台架和临床前测试。目的4）设计并制作一种体积小、携带方便、界面友好的DCS/DOS床边监护仪。目的5）完成第二代探头和监护仪的台架测试和临床前测试。

 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.