Spinal blocks are administered by anesthesiologists for a variety of lower body surgeries including genitourinary tract procedures, cesarean sections, orthopedic hip or knee replacements, and lower abdominal surgeries like hernia repairs. Spinal anesthesia is achieved by a single shot of medication into the subarachnoid space to produce numbness from the umbilicus down. Onset is within a few minutes and effects last up to two hours, offering reliable and rapid onset anesthesia for a safe and effective alternative to general anesthesia. After a spinal block is done, it is often supplemented with light or moderate sedation for patient comfort, though the block alone is sufficient anesthesia for surgery.
The technique involves palpating for bony landmarks and identifying the L3-L4 or L4-L5 intervertebral spaces. Once identified, the skin is numbed with local anesthetic, and then the spinal needle is inserted at the midline via an introducer needle. When cerebrospinal fluid is aspirated to confirm that the needle is in the subarachnoid space, the medication is injected, the needle is removed, and the procedure is complete.
This current technique is “highly unpredictable and requires significant guesswork,” according to startup biomedical company IntuiTap Medical. The bony landmarks can sometimes be difficult to palpate, especially in obese patients or patients with scoliosis or history of spinal manipulation. Consequently, multiple needle insertion attempts may be necessary to correctly identify the intrathecal space, causing frustration and stress for both patient and physician, as well as increased risk of post-dural puncture headaches. These complications can prolong the procedure, increase risk of readmission, and threaten patient satisfaction.
IntuiTap wants physicians to succeed on the first try. The company has created a device that integrates imaging of the spine with needle guidance and analytics. The handheld device enhances palpation by displaying a real-time image of the underlying bone on a handheld LCD screen and, using an algorithm, projecting exactly where the needle will go if inserted at that exact position. A digital pressure sensor confirms the location of the needle and measures opening pressure at the same time so the physician does not need to use a separate manometer device.
The cofounders of IntuiTap CEO Jessica Traver and CTO Nicole Moskowitz were both featured in Forbes annual list of 30 under 30 for healthcare in 2017. Over the past year, IntuiTap has started seed funding rounds and has been awarded space at Johnson & Johnson Innovation’s JLABS and taken part in TMCx and MedTech Innovator accelerator programs.