Clinical Application of Near Infrared Blood Oxygen Monitoring in Cervical Spinal Cord Injury

Author(s): Jamal Alshorman, Ruba Altahla, Gao Yana, Liu Xiangyan

Background:

It has always been a challenge for orthopedic surgeons worldwide, to detect the blood flow after cervical spinal cord injury (CSCI). How to non-invasively, real time, and quantitatively evaluate the blood supply and injury degree of the spinal cord during the operation, and how to guide the selection of laminectomy and durotomy?

Objective:

To investigate the feasibility of using NIR-SO2 (Near infrared light-Oxygen saturation) monitoring for CSCI and to determine whether NIR can provide a non-invasive, real time, and quantitative assessment of the degree of spinal cord decompression and the need for a durotomy.

Methods:

This study collected 37 CSCI cases from June 2023 to October 2024. Inclusion criteria: patients aged >18 years; patients with cervical fracture and/or dislocation, ASIA grades A, B, and C; treated with a posterior approach. Exclusion criteria: patients aged <18 years; ASIA grade D or E, no cervical fracture and/or dislocation; SCI treated conservatively; patients with normal MRI and no neurological symptoms; patients with spinal tumors. However, apply NIR-SO2 technology to detect regional SO2 under light-proof conditions.

Results:

This study collected 37 patients; 23 males (62.2%) and 14 females (37.8%). The patients' ages was 51.4±9.7 years. The admissionto- operation time was 51.9±9.1 hours. The ASIA grades improved during the last follow-up. The NIR-SO2 in 22 patients before laminectomy was 53.7±1.6%, and after laminectomy was 65.1±1.6% (P<0.01). Therefore, in 15 patients before laminectomy, the NIR-SO2 was 39.7±1.6%, improving to 42.3±2.6% after laminectomy and increasing to 62.7±3.1% after durotomy and duroplasty with a statistical difference before and after durotomy (P<0.01).

Conclusion:

NIR-SO2 technology is safe and feasible and directly reflects the improvement of spinal cord blood supply. NIR-SO2 technology can monitor the regional SO2 of CSCI patients and assess spinal cord perfusion and compression in real time.