Ultrasound neural interface enabling acute spinal cord monitoring and blood flow modulation
Max J. Kerensky, Siddharth Krishnan, Ruixing Liang, Kelley M. Kempski Leadingham, Victor M. Quiroz, Joshua Punnoose, Constantin Smit, Denis Routkevitch, Avisha Kumar, A. Daniel Davidar, Leonard Steger, Carly Weber-Levine, Kelly Jiang, Meghana Bhimreddy, Stuart J. Bauer, Angelica F. Lopez, Patrick Kramer, Kayla Robinson, Arjun K. Menta, Abdul Karim Ghaith, Andrew M. Hersh, Haley G. Abramson, Ali Mohammadabadi, John N. Theodore, Osamah M. Zmily, Ritvik Jillala, Vikas Vattipally, David Kopala, Siavash S. Barough, Mohammad Hossein Amini, Jonathan Maltz, Francisco Chavez, Kyle Morrison, Laura Roy, Ian Suk, Ryan P. Lee, Betty Tyler, Mark Luciano, Nitish V. Thakor, Joshua C. Doloff, Nicholas Theodore, Amir ManbachiThe days following decompression surgery for acute spinal cord injury (SCI) are a critical period for postoperative monitoring. After wound closure, clinicians lack on-demand access to local spinal cord morphology and hemodynamics, and care therefore remains guided largely by systemic surrogates rather than direct postoperative insight into the injured cord. We present the Multimodal Ultrasound System for Injury Care (MUSIC), a temporary epidural ultrasound neural interface placed during standard decompression surgery to enable postoperative brightness-mode imaging, Doppler-derived hemodynamic monitoring, and future device-integrated ultrasound actuation. Across simulations, benchtop, human cadaveric, and porcine studies, MUSIC enabled on-demand visualization of cord structure, hematoma tracking, detection and longitudinal tracking of localized Doppler flow signatures attributable to the sulcal artery region, and, in healthy pigs, proof-of-concept focused ultrasound modulation of blood-flow velocity. MUSIC establishes a temporary postoperative acoustic interface that provides spinal cord information to inform monitoring, future management, and localized intervention strategies after SCI.