An ultrasound device the size of a small band-aid, placed over the spinal cord at the injury site during planned surgery after spinal cord injury, could change the way surgeons deliver care.
Temporarily implanting a tiny ultrasonic device at the spinal cord injury site may be feasible, safe and potentially useful.
This is the conclusion of the first feasibility study.
A team of engineers and surgeons at Johns Hopkins Medicine in the US has published its first proof of concept.
The findings, marking an early midpoint in a multi-tiered research journey to develop and study how the device could be used in clinical care, are published in Science Advances.
Amir Manbachi, the principal investigator and an associate professor of neurosurgery and biomedical engineering at the Johns Hopkins University School of Medicine, said: ‘When the biology of spinal cord injury is local, our devices should also be able to track and treat local physiology.’
The device – Multimodal Ultrasound System for Injury Care (MUSIC) – is designed to enhance feedback on what is happening at and around the injury site after surgery.
It also supports clinical decision-making regarding care when a patient is recovering in an intensive care unit.
The ultimate goal is to identify a way to support people while they are in hospital and to minimise the risk of complications, such as stroke, blindness or further loss of movement, that they may face while recovering from a spinal cord injury.
The device is designed to double as a ‘mobile MRI’ that could reduce the need to move immobile patients in the days following their recovery, while providing on-demand feedback to medical teams, rather than at single points in time.
It combines diagnostic ultrasound (sonography) and therapeutic ultrasound (physical therapy):
- The diagnostic/imaging aspect of the device provides real-time insight into blood flow and changes around the spinal cord injury, and enables analysis of other measures, such as spinal fluids and excess fluid accumulation, how a person is responding to medication, and what is happening outside the injured area, which can provide insight into how well a person is healing. This real-time detection in the days and weeks after surgery could provide instant feedback to medical teams while helping to personalise treatment decisions.
- The therapeutic ultrasound (focused ultrasound) is the more exploratory aspect of the device, which has been studied for its potential to identify and respond to changes in blood flow at and around the site of the injury (when blood flow through the small vessels around the affected area drops below or rises above acceptable levels).
Nicholas Theodore, a former neurosurgeon at Johns Hopkins and a current adjunct professor of medicine, who created the device with Manbachi, said: ‘Timing is critical for recovery. This research represents a fusion of multiple industries, disciplines and applications that we envision has the power to fine-tune and personalise the care that a person receives following their surgery, which could support and improve their health outcomes months and years later.’
