Abstract
Study design
Review.
Objectives
Clinical studies have shown that the hemodynamic management of patients following acute spinal cord injury (SCI) is an important aspect of their treatment for maintaining spinal cord (SC) perfusion and minimizing ischemic secondary injury to the SC. While this highlights the importance of ensuring adequate perfusion and oxygenation to the injured cord, a method for the real-time monitoring of these hemodynamic measures within the SC is lacking. The purpose of this review is to discuss current and potential methods for SC hemodynamic monitoring with special focus on applications using near-infrared spectroscopy (NIRS).
Methods
A literature search using the PubMed database. All peer-reviewed articles on NIRS monitoring of SC published from inception to May 2019 were reviewed.
Results
Among 125 papers related to SC hemodynamics monitoring, 26 focused on direct/indirect NIRS monitoring of the SC.
Discussion
Current options for continuous, non-invasive, and real-time monitoring of SC hemodynamics are challenging and limited in scope. As a relatively new technique, NIRS has been successfully used for monitoring human cerebral hemodynamics, and has shown promising results in intraoperative assessment of SC hemodynamics in both human and animal models. Although utilizing NIRS to monitor the SC has been validated, applying NIRS clinically following SCI requires further development and investigation.
Conclusions
NIRS is a promising non-invasive technique with the potential to provide real-time monitoring of relevant parameters in the SC. Currently, in its first developmental stages, further clinical and experimental studies are mandatory to ensure the validity and safety of NIRS techniques.
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Acknowledgements
BS holds a Scholar Award from the Michael Smith Foundation for Health Research. BKK is the Canada Research Chair in Spinal Cord Injury and the Dvorak Chair in Spine Trauma.
Author Contributions
TR was responsible for conducting the study and manuscript preparation. AM contributed to the study by analyzing the findings and drafting the manuscript. AC contributed to the study by article searching and manuscript preparation. AS contributed to the study by manuscript and graphic preparations. BK contributed the study by analyzing the findings, guiding the discussions, and reviewing the manuscript. BS was responsible for proposing and supervising the study and drafting the manuscript.
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Rashnavadi, T., Macnab, A., Cheung, A. et al. Monitoring spinal cord hemodynamics and tissue oxygenation: a review of the literature with special focus on the near-infrared spectroscopy technique. Spinal Cord 57, 617–625 (2019). https://doi.org/10.1038/s41393-019-0304-2
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DOI: https://doi.org/10.1038/s41393-019-0304-2
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