Abstract
.Significance: Imaging of the spinal cord is challenging due to the surrounding bony anatomy, physiologic motion, and the small diameter of the spinal cord. This precludes the use of non-invasive imaging techniques in assessing structural changes related to trauma and evaluating residual function.Aim: The purpose of our research was to apply endovascular technology and techniques and construct a preclinical animal model of intrathecal spinal cord imaging using optical coherence tomography (OCT).Approach: Five animals (2 Yorkshire Swine and 3 New Zealand Rabbits) were utilized. Intrathecal access was gained using a 16-guage Tuohy, and an OCT catheter was advanced under roadmap technique into the cervical canal. The OCT catheter has a motorized pullback, and a total length of 54 mm of the spinal canal is imaged.Results: Image acquisition was successful for all animals. There were no instances of difficult catheter navigation, enabling OCT imaging rostrally to C2. The thecal sac provided excellent thoroughfare for the OCT catheter. The clear cerebrospinal fluid also provided an excellent medium for image acquisition, with no detectable artifact from the contents of the cerebrospinal fluid. The anatomical space of the spinal canal could be readily appreciated including: dural lining of the thecal sac, epidural veins, pial lining of the spinal cord, arachnoid bands, dentate ligaments, and nerve rootlets/roots.Conclusion: Minimally invasive intrathecal imaging using endovascular OCT was feasible in this preclinical animal study. The repurposing of an endovascular device for spinal imaging comes with limitations, and a spine-specific device is necessary.
Highlights
Diagnostic imaging of the spinal canal has evolved considerably over the past two decades.[1]
Significant progress has been made at assessing structural changes related to trauma and evaluating residual function, non-invasive spinal cord imaging modalities continue to be hindered by susceptibility differences, motion secondary to cardiac function, and the small cross-sectional area of the spinal cord leading to limited clinical utility.[4,5,6,7]
Lumbar puncture via Tuohy needle was achieved, and the optical coherence tomography (OCT) catheter was passed through the needle and navigated throughout the spinal canal successfully in all cases
Summary
Diagnostic imaging of the spinal canal has evolved considerably over the past two decades.[1] Non-invasive imaging modalities are the radiological tools of choice for the majority of spinal pathologies including: trauma, tumors, infections, and inflammatory disease.[2] In spinal trauma, computed tomography (CT) is very sensitive in the detection of fractures or dislocations, and magnetic resonance (MR) imaging can reliably identify cord compression, transections, edema, and hemorrhages.[3] significant progress has been made at assessing structural changes related to trauma and evaluating residual function, non-invasive spinal cord imaging modalities continue to be hindered by susceptibility differences, motion secondary to cardiac function, and the small cross-sectional area of the spinal cord leading to limited clinical utility.[4,5,6,7]. In 1991, a technology called optical coherence tomography (OCT) was developed by Huang et al.[8] who first demonstrated the technique and its application on the human retina and coronary artery in vitro. The cross-sectional images generated using OCT utilize backscattered light from the tissue structure.
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