Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.

Spinal cord ischemia leads to iatrogenic injury in multiple surgical fields, and the ability to immediately identify onset and anatomic origin of ischemia is critical to its management. Current clinical monitoring, however, does not directly measure spinal cord blood flow, resulting in poor sensitiv...

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Autores principales:	David R Busch, Wei Lin, Chia Chieh Goh, Feng Gao, Nicholas Larson, Joseph Wahl, Thomas V Bilfinger, Arjun G Yodh, Thomas F Floyd
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/560c312cc51d42dfb224152e5a9592b0
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spelling	oai:doaj.org-article:560c312cc51d42dfb224152e5a9592b02021-12-02T20:11:25ZTowards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.1932-620310.1371/journal.pone.0251271https://doaj.org/article/560c312cc51d42dfb224152e5a9592b02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251271https://doaj.org/toc/1932-6203Spinal cord ischemia leads to iatrogenic injury in multiple surgical fields, and the ability to immediately identify onset and anatomic origin of ischemia is critical to its management. Current clinical monitoring, however, does not directly measure spinal cord blood flow, resulting in poor sensitivity/specificity, delayed alerts, and delayed intervention. We have developed an epidural device employing diffuse correlation spectroscopy (DCS) to monitor spinal cord ischemia continuously at multiple positions. We investigate the ability of this device to localize spinal cord ischemia in a porcine model and validate DCS versus Laser Doppler Flowmetry (LDF). Specifically, we demonstrate continuous (>0.1Hz) spatially resolved (3 locations) monitoring of spinal cord blood flow in a purely ischemic model with an epidural DCS probe. Changes in blood flow measured by DCS and LDF were highly correlated (r = 0.83). Spinal cord blood flow measured by DCS caudal to aortic occlusion decreased 62%. This monitor demonstrated a sensitivity of 0.87 and specificity of 0.91 for detection of a 25% decrease in flow. This technology may enable early identification and critically important localization of spinal cord ischemia.David R BuschWei LinChia Chieh GohFeng GaoNicholas LarsonJoseph WahlThomas V BilfingerArjun G YodhThomas F FloydPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251271 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David R Busch Wei Lin Chia Chieh Goh Feng Gao Nicholas Larson Joseph Wahl Thomas V Bilfinger Arjun G Yodh Thomas F Floyd Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
description	Spinal cord ischemia leads to iatrogenic injury in multiple surgical fields, and the ability to immediately identify onset and anatomic origin of ischemia is critical to its management. Current clinical monitoring, however, does not directly measure spinal cord blood flow, resulting in poor sensitivity/specificity, delayed alerts, and delayed intervention. We have developed an epidural device employing diffuse correlation spectroscopy (DCS) to monitor spinal cord ischemia continuously at multiple positions. We investigate the ability of this device to localize spinal cord ischemia in a porcine model and validate DCS versus Laser Doppler Flowmetry (LDF). Specifically, we demonstrate continuous (>0.1Hz) spatially resolved (3 locations) monitoring of spinal cord blood flow in a purely ischemic model with an epidural DCS probe. Changes in blood flow measured by DCS and LDF were highly correlated (r = 0.83). Spinal cord blood flow measured by DCS caudal to aortic occlusion decreased 62%. This monitor demonstrated a sensitivity of 0.87 and specificity of 0.91 for detection of a 25% decrease in flow. This technology may enable early identification and critically important localization of spinal cord ischemia.
format	article
author	David R Busch Wei Lin Chia Chieh Goh Feng Gao Nicholas Larson Joseph Wahl Thomas V Bilfinger Arjun G Yodh Thomas F Floyd
author_facet	David R Busch Wei Lin Chia Chieh Goh Feng Gao Nicholas Larson Joseph Wahl Thomas V Bilfinger Arjun G Yodh Thomas F Floyd
author_sort	David R Busch
title	Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
title_short	Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
title_full	Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
title_fullStr	Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
title_full_unstemmed	Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
title_sort	towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/560c312cc51d42dfb224152e5a9592b0
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Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.

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