Intraoperative Nerve Guidance With Real-Time Function Feedback
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
The lack of objective, real-time guidance during spinal decompression surgery leads to variability in decompression procedures, risking under- or over-decompression, which can result in complications such as spinal instability, dural tears, or the need for subsequent procedures.
Innovation Solution
A system comprising a stimulator, sensor, and processor that delivers electrical stimuli to nerves, detects muscle responses, and provides real-time feedback using sophisticated algorithms to determine nerve function parameters, with integration of historical data and machine learning for personalized and risk assessment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If surgeons rely on clinical judgment and visual inspection to guide decompression, then procedural flexibility is maintained, but objective measurement and real-time feedback are lost leading to under- or over-decompression
Solution Approach 1:
The system implements real-time feedback by continuously monitoring nerve function parameters (stimulation threshold, supramaximal threshold, muscle response magnitude) and comparing them against target ranges for fully decompressed nerves. The processor provides immediate feedback to guide the surgeon on whether to continue or stop decompression, transforming subjective visual inspection into objective, data-driven decision-making.
Solution Approach 2:
The patent replaces the mechanical/visual inspection system with an electrical stimulation and sensor-based measurement system. Instead of relying on visual assessment of decompression extent, the system uses electrical stimuli to evoke muscle responses and quantifies nerve function through measured parameters, substituting mechanical judgment with electrical physiological measurement.
2Reliability
If more extensive decompression is performed to ensure complete nerve relief, then under-decompression is prevented, but spinal instability and dural tears increase
Solution Approach 1:
The system prevents both under- and over-decompression through real-time feedback. By continuously monitoring nerve function parameters and comparing them to target ranges, the system identifies the optimal decompression endpoint when nerve function is fully restored. This eliminates the need for excessive decompression while ensuring complete nerve relief, as the processor provides precise guidance on when to stop the procedure.
Solution Approach 2:
The patent applies the principle of avoiding excessive action by using objective measurement to determine the precise point of adequate decompression. Instead of performing extensive decompression beyond what is necessary, the system identifies when nerve function parameters indicate sufficient decompression has been achieved, preventing harmful over-decompression while ensuring complete nerve relief.
3Measurement precision
If repeated electrical stimuli are used to determine nerve parameters, then measurement accuracy improves, but patient discomfort and nerve fatigue increase
Solution Approach 1:
The system determines nerve function parameters using the minimum necessary number of electrical stimuli to achieve accurate measurements. By using sophisticated algorithms to analyze muscle response patterns and calculate parameters like stimulation threshold and supramaximal threshold, the system obtains precise nerve function data without requiring excessive repeated stimulation, thereby minimizing patient discomfort and nerve fatigue while maintaining measurement accuracy.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Optimizes decompression procedures by reducing complications, improving surgical outcomes, and enhancing patient care through objective, real-time nerve function monitoring.
Implementation Method 1
a stimulator configured to deliver electrical stimuli to a nerve
Implementation Method 2
a sensor configured to detect muscle responses evoked by the electrical stimuli
Data Source
AI summary
A method for intraoperative guidance during a surgical procedure involving a nerve includes receiving real-time image data from an intraoperative imaging modality, the real-time image data depicting anatomical structures within an intracorporeal treatment area including the nerve; determining at least one nerve function parameter indicative of nerve health; and controlling a display device to concurrently present a visual output comprising both a visual representation derived from the real-time image data and a visual indication of the determined at least one nerve function parameter. The concurrently presented visual output facilitates assessment of the nerve relative to the anatomical structures during the surgical procedure.