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Cerebrospinal fluid pressure measurement in the ovine intrathecal space: a preliminary study towards the diagnosis of intrathecal drug administration catheter dislodgement or occlusion.
MedLine Citation:
PMID:  20733347     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Intrathecal drug delivery catheter malfunctions are a principal cause of therapy interruption. We determined that normal baseline intrathecal cerebrospinal fluid (CSF) pressure recordings could be obtained in an ovine model and in a catheter dislodgement scenario.
METHODS: Two sheep were implanted with spinal catheters: 2 in the T(6) epidural space in sheep No. 1; 1 T(6) intrathecal catheter plus 1 L(2) epidural catheter with a deliberate CSF leak to simulate dislodgement in sheep No. 2. Pressure waves were recorded intraoperatively and at multiple times after the implantation in the awake condition. On day 21, the animals were anesthetized for pressure recordings while on and temporarily off mechanical ventilation. They were then necropsied.
RESULTS: CSF pressure waves were obtained in this animal model under anesthesia with or without mechanical ventilation and in the awake state. Fluid accumulation at the tip of a dislodged (epidural) catheter temporarily caused apparent coupling of fluid pressures across the dura. An unintentional extraspinal fluid collection in sheep No. 2 was associated with a raised baseline epidural pressure.
CONCLUSIONS: These findings support the notion that pressure sensors can play a role in determining the status of intraspinal drug delivery catheters.
Authors:
Robert J Coffey; Keith Miesel; Tina Billstrom
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Publication Detail:
Type:  Journal Article     Date:  2010-08-21
Journal Detail:
Title:  Stereotactic and functional neurosurgery     Volume:  88     ISSN:  1423-0372     ISO Abbreviation:  Stereotact Funct Neurosurg     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902881     Medline TA:  Stereotact Funct Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  337-44     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Neuromodulation Clinical and Emerging Therapies, Medtronic, Inc., Minneapolis, Minn., USA. robert.coffey @ medtronic.com
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