Codman microsensor transducer

Manufactured by DePuy

Sourced in United Kingdom

The Codman Microsensor Transducer is a medical device designed to measure intracranial pressure. It is a small, implantable sensor that is used to monitor pressure within the brain or surrounding cerebrospinal fluid. The device converts the pressure measurements into electrical signals, which can then be monitored and analyzed by healthcare professionals.

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Lab products found in correlation

Tisseel, by Baxter (2 mentions) Intellivue mx800 monitor, by Philips (1 mentions) Labchart v7, by ADInstruments (1 mentions) Intellivue mx800, by Philips (1 mentions)

6 protocols using codman microsensor transducer

Intraspinal Probe and Microdialysis Insertion

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An ISP probe (Codman Microsensor Transducer, Depuy Synthes, Leeds, UK) and a MD catheter (CMA 61, CMA microdialysis AB, Sweden) were tunnelled through the skin into the wound cavity. Under the operating microscope, the dura and arachnoid were opened one level below the injury. The ISP probe and MD catheter were inserted through the durotomy and advanced on the cord surface until the tips were at the site of maximal cord swelling. The dural opening was sutured and supplemented with Tisseel (Baxter, UK). The ISP probe and MD catheter were sutured to the skin. These techniques are described in detail in our earlier publications^{16 (link)–23 (link)}.

Gallagher M.J., Hogg F.R., Kearney S., Kopp M.A., Blex C., Serdani L., Sherwood O., Schwab J.M., Zoumprouli A., Papadopoulos M.C, & Saadoun S. (2020). Effects of local hypothermia–rewarming on physiology, metabolism and inflammation of acutely injured human spinal cord. Scientific Reports, 10, 8125.

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Monitoring Spinal Cord Perfusion Pressure

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After posterior decompression of the spinal cord, under the operating microscope, a pressure probe (Codman Microsensor Transducer®, Depuy Synthes, Leeds, UK) was placed intradurally between the dura and injured cord at the site of maximal cord swelling and secured to the skin with silk sutures. The pressure probe was connected to a Codman ICP box. Arterial blood pressure (ABP) was recorded from a radial artery catheter. Both ISP and ABP interface with the ICU Philips Intellivue MX800 monitor (Philips, Guildford, U.K.), which is connected to a laptop running ICM+ recording software (Cambridge, U.K). ISP and ABP signals were sampled at 500 kHz and used to compute SCPP as mean arterial pressure (MAP) minus ISP. ISP is the same as intraparenchymal cord pressure at the injury site [14 (link)], which differs from cerebrospinal fluid (CSF) pressure measured above or below the injury because the swollen, injured cord is compressed against the dura, thus compartmentalising the intrathecal space as described in earlier publications [2 (link), 15 (link), 16 (link)]. Figure 1 shows the setup.Fig. 1

Monitoring from the injured spinal cord. A Pressure probe at the injury site monitors ISP, arterial line monitors MAP, and SCPP is computed as MAP–ISP. B Example of MAP, ISP and SCPP signals from a C4 AIS B TSCI patient

Visagan R., Boseta E., Zoumprouli A., Papadopoulos M.C, & Saadoun S. (2023). Spinal cord perfusion pressure correlates with breathing function in patients with acute, cervical traumatic spinal cord injuries: an observational study. Critical Care, 27, 362.

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Intradural Spinal Pressure Monitoring

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After bony realignment and posterior fixation, the ISP probe (Codman Microsensor Transducer®, Depuy Synthes, Leeds, UK) was placed intradurally on the spinal cord surface at the site of maximal cord swelling. The probe monitors pressure, which is generated by the swollen injured cord compressed against the dura. These ISP recordings differ from corresponding values obtained from proximal or distal cord or extradurally. The ISP monitoring technique is illustrated in Figure 1. Details are given elsewhere (5 (link), 6 (link), 9 (link)–12 (link), 15 (link), 16 (link)).

Chen S., Gallagher M.J., Papadopoulos M.C, & Saadoun S. (2018). Non-linear Dynamical Analysis of Intraspinal Pressure Signal Predicts Outcome After Spinal Cord Injury. Frontiers in Neurology, 9, 493.

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Intradural Spinal Pressure Monitoring

Cited 1 time

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Surgical decompression and spinal instrumentation were performed based on patient requirements and surgeon preference. Some patients also had duroplasty as described [12 (link)]. During surgery, an ISP probe (Codman Microsensor Transducer^®, Depuy Synthes, Leeds, UK) was placed intradurally on the surface of the injured cord at the site of maximal cord swelling. The dural opening was sutured and supplemented with fibrin glue (Tisseel^®, Baxter, UK). The ISP probe was connected to a Codman ICP box linked via a ML221 amplifier to a PowerLab running LabChart v.7.3.5 (AD Instruments, Oxford, UK). Arterial blood pressure was recorded from a radial artery catheter connected to the Philips Intellivue MX800 bedside monitoring system (Philips, Guildford, UK), and in turn connected to the PowerLab system. ISP and arterial blood pressure signals were sampled at 1 kHz for 24 h after surgery. When the spinal cord is swollen and compressed against the dura, the subdural pressure (i.e., ISP) and intraparenchymal pressure at the injury site are the same. In this case, ISP is higher than cerebrospinal fluid (CSF) pressure above or below the injury site—details are given elsewhere [5 (link), 6 (link), 13 (link)–15 (link)].

Hogg F.R., Gallagher M.J., Chen S., Zoumprouli A., Papadopoulos M.C, & Saadoun S. (2018). Predictors of Intraspinal Pressure and Optimal Cord Perfusion Pressure After Traumatic Spinal Cord Injury. Neurocritical Care, 30(2), 421-428.

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Intradural Pressure Monitoring Technique

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During posterior surgery, a pressure probe (Codman Microsensor Transducer; DePuy Synthes, Leeds, UK) was inserted through the skin into the wound cavity. Using a microscope, the dura and arachnoid were opened one level below the injury. The pressure probe was inserted intradurally, with the tip placed at the site of maximal cord swelling. The dural opening was sutured. This technique is described in detail elsewhere [6 (link), 9 (link), 10 (link), 12 (link), 13 (link), 15 (link), 18 (link), 19 (link)]. ISP measured this way differs from intrathecal pressure measured above or below the injury site because the injured cord is compressed against the dura, thus compartmentalizing the intrathecal space [15 (link), 20 (link)–22 (link)].

Hogg F.R., Kearney S., Gallagher M.J., Zoumprouli A., Papadopoulos M.C, & Saadoun S. (2021). Spinal Cord Perfusion Pressure Correlates with Anal Sphincter Function in a Cohort of Patients with Acute, Severe Traumatic Spinal Cord Injuries. Neurocritical Care, 35(3), 794-805.

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Intradural Pressure and Microdialysis Monitoring

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During posterior surgery, an ISP probe (Codman microsensor transducer, DePuy Synthes) and a microdialysis (MD) catheter (CMA61, CMA Microdialysis AB) were inserted through the skin into the wound cavity. Using a microscope, the dura plus arachnoid were opened one level below the injury. The ISP probe and MD catheter were inserted intradurally with the tips placed at the site of maximal cord swelling (Fig. 1A). The dural opening was sutured. These techniques are described elsewhere. 4, 6, 8, [10] [11] [12] 14, 21 ISP and MD measured under the conditions of this study differ from intrathecal pressure and MD measured above or below the injury site because the injured cord is compressed against the dura, thus compartmentalizing the intrathecal space. 14, [22] [23] [24]

Hogg F.R.A., Kearney S., Solomon E., Gallagher M.J., Zoumprouli A., Papadopoulos M.C, & Saadoun S. (2022). Acute, severe traumatic spinal cord injury: improving urinary bladder function by optimizing spinal cord perfusion. Journal of neurosurgery. Spine, 36(1).

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