20 February 2018 Optical monitoring of spinal cord subcellular damage after acute spinal cord injury
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Introduction: Sudden physical trauma to the spinal cord results in acute spinal cord injury (SCI), leading to spinal cord (SC) tissue destruction, acute inflammation, increased SC intraparenchymal pressure, and tissue ischemia, hypoxia, and cellular necrosis. The ability to monitor SC tissue viability at subcellular level, using a real-time noninvasive method, would be extremely valuable to clinicians for estimating acute SCI damage, and adjusting and monitoring treatment in the intensive care setting. This study examined the feasibility and sensitivity of a custommade near infrared spectroscopy (NIRS) sensor to monitor the oxidation state of SC mitochondrial cytochrome aa3 (CCO), which reflects the subcellular damage of SC tissue in an animal model of SCI.

Methods: Six anesthetized Yorkshire pigs were studied using a custom-made multi-wavelength NIRS system with a miniaturized optical sensor applied directly on the surgically exposed SC at T9. The oxidation states of SC tissue hemoglobin and CCO were monitored before, during and after acute SCI, and during mean arterial pressure alterations.

Results: Non-invasive NIRS monitoring reflected changes in SC tissue CCO, simultaneous but independent of changes in hemoglobin saturation following acute SCI. A consistent decrease in SC tissue CCO chromophore concentration (-1.98 ± 2.1 ab, p<0.05) was observed following SCI, indicating progressive SC cellular damage at the injury site. Elevation of mean arterial pressure can reduce SC tissue damage as suggested by different researchers and observed by significant increase in SC tissue CCO concentration (1.51 ± 1.7 ab, p<0.05) in this study.

Conclusions: This pilot study indicates that a novel miniaturized multi-wave NIRS sensor has the potential to monitor post-SCI changes of SC cytochrome aa3 oxygenation state in real time. Further development of this method may offer new options for improved SCI care.
© (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Babak Shadgan, Babak Shadgan, Neda Manouchehri, Neda Manouchehri, Kitty So, Kitty So, Katelyn Shortt, Katelyn Shortt, Allan Fong, Allan Fong, Femke Streijger, Femke Streijger, Andrew Macnab, Andrew Macnab, Brian K. Kwon, Brian K. Kwon, } "Optical monitoring of spinal cord subcellular damage after acute spinal cord injury", Proc. SPIE 10501, Optical Diagnostics and Sensing XVIII: Toward Point-of-Care Diagnostics, 105010L (20 February 2018); doi: 10.1117/12.2286551; https://doi.org/10.1117/12.2286551

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