Thomas F Floyd
Interim Division Chief of Cardiac Anesthesia, Stony Brook University, USA
Title: Spinal fiber optic monitoring
Biography
Biography: Thomas F Floyd
Abstract
Spinal cord ischemia results in life-changing paralysis and paraparesis after major vascular, spine and spinal cord surgery, and spine trauma. No technology is currently available to directly and immeadiately predict or detect the onset of spinal cord ischemia, nor provide feedback and guidance for interventions directed at improving flow and oxygen delivery to resolve the ischemia. Current methods employed to detect spinal cord ischemia, based upon electrophysiology, are indirect, temporally insensitive, nonspecific, as only 16%–40% of patients with electrophysiological changes developed postoperative-onset paraparesis, paraplegia, or quadriplegia. The reliability of the current technology is simply not good enough. We have developed a prototypical fiber optic device based on Diffuse Correlation Spectroscopy (DCS) and Diffuse Optical Spectroscopy (DOS) principles that allows for the immediate detection and continuous monitoring of changes in spinal cord blood flow and oxygenation. The device prototype can be placed via open and percutaneous approaches. The ability to measure spinal cord blood flow and oxygenation will: 1) facilitate expeditious diagnosis and monitoring of the progress of spinal cord ischemia; 2) enable continuous bedside monitoring in the neurocritical care setting; 3) offer an enhanced opportunity to prevent secondary injury; 4) provide critical data in the laboratory and clinic for assessment of the efficacy of therapeutic approaches to ameliorate ischemia, and 5) provide preoperative and intraoperative data to improve decision making for procedures where the spinal cord may be threatened.