OCT-Guided Interventions for Pain Management

描述（由申请人提供）： 脊髓硬膜外腔是骨性椎管内难以进入的部位，每年在此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管理。在这个国家，每年有200万到300万例产科镇痛手术。相当数量的硬膜外麻醉程序作为其他手术适应症的一部分进行。据估计，腰痛每年给美国经济造成超过500亿美元的负担。病变通常位于硬膜外腔内或紧邻硬膜外腔。现有的临床成像技术无法提供该空间内的治疗干预所需的空间分辨率或实时能力。有一个很大的未满足的需要，能够清晰地成像实时结构，如个别神经根，血管，硬脑膜，游离椎间盘碎片，和纤维疤痕组织内和邻近的脊髓硬膜外腔。光学相干断层扫描（OCT）是一种新兴技术，非常适合在椎管内成像。本项目的第一个目标是修改和调整基于导管的OCT技术，以应用于脊柱。第二个目标是确定OCT引导的急性和慢性疼痛管理干预的可行性和优势。这将是一个学术医疗中心和基于导管的OCT技术的行业领导者之间的合作。

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.