Nerve Response Waveform Integration for Neuropraxia Detection

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Solution Overview

Problem

Current methods for detecting reversible nerve injury, such as neuropraxia, during surgery are unreliable and inefficient, often leading to misdiagnosis due to reliance on voltage response algorithms that are costly, time-consuming, and do not accurately reflect nerve integrity or the degree of injury.

Innovation Solution

The method involves mathematical integration of nerve response waveforms to provide a more reliable and accurate indication of nerve health, using evoked or free-run EMG responses, and comparing integration values to a threshold to quantify the extent of nerve injury.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If voltage response algorithms are used to detect nerve injury, then nerve response can be measured, but the method is unreliable and leads to misdiagnosis

Engineering Contradiction:

Improvenerve injury detection accuracyVSAvoiddiagnosis reliability

Core Design Contradiction:

Measurement precisionVSReliability

Solution Approach 1:

The patent changes the measurement parameter from voltage response to waveform integration (area under the curve). This parameter transformation provides a more reliable indicator of nerve response strength, eliminating the misdiagnosis issues associated with voltage algorithms while maintaining the ability to detect nerve injury.

Inventive Principle:

Principle #35Parameter changes

Solution Approach 2:

The patent replaces the electrical voltage measurement system with a mathematical integration system. By calculating the area under the waveform curve rather than measuring voltage directly, the system achieves more reliable nerve injury detection without the false positives and negatives inherent in voltage-based methods.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

2Reliability

If implantable stimulator probes are used for nerve monitoring, then continuous monitoring is possible, but the cost and complexity increase

Engineering Contradiction:

Improvemonitoring reliabilityVSAvoiddevice complexity

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The patent uses a handheld stimulation probe that replicates the function of implantable probes without the need for surgery. The probe temporarily contacts the nerve externally, providing all necessary monitoring capabilities while avoiding the complexity and cost of implantable devices.

Inventive Principle:

Principle #26Copying

Solution Approach 2:

The patent employs a disposable handheld probe that is inexpensive and does not require implantation. This single-use device provides reliable nerve monitoring during surgery without the ongoing costs and surgical complexity associated with implantable stimulator probes.

Inventive Principle:

Principle #27Cheap short-living objects (Disposable)

3Ease of operation

If voltage amplitude is used to assess nerve strength, then measurement is simple, but the method does not accurately reflect nerve integrity

Engineering Contradiction:

Improvemeasurement simplicityVSAvoidnerve integrity assessment accuracy

Core Design Contradiction:

Ease of operationVSMeasurement precision

Solution Approach 1:

The patent transforms the measurement from voltage amplitude to waveform integration. This parameter change maintains operational simplicity while dramatically improving accuracy, as the integrated area under the curve provides a true reflection of nerve response strength and integrity.

Inventive Principle:

Principle #35Parameter changes

4Adaptability or versatility

If manual stimulation probe is used instead of automatic ping testing, then flexibility increases, but time consumption increases

Engineering Contradiction:

Improvetesting flexibilityVSAvoidtesting time

Core Design Contradiction:

Adaptability or versatilityVSLoss of time

Solution Approach 1:

The patent incorporates automatic waveform integration analysis that processes results instantly. This maintains the flexibility of manual probe positioning while eliminating time consumption through automated real-time analysis of the stimulation responses.

Inventive Principle:

Principle #35Parameter changes

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

This approach offers a more accurate and efficient means of detecting neuropraxia by correlating the area under the waveform with nerve/muscle response power, providing early warnings of impending nerve damage and enabling proactive measures to prevent injury during surgical procedures.

Implementation Method 1

an electronic nerve stimulator elicits an evoked electromyographic response

Methodology Applied

Scientific EffectElectrical stimulation: Electrical Impedance Tomography

Implementation Method 2

the response is detected by pickup electrodes

Methodology Applied

Scientific EffectElectromyographic response detection:

Data Source

PatentUS10517493B2Detection of reversible nerve injury

Publication Date: 2019.12.31 NEUROVISION MEDICAL PRODS

AI summary

A system for monitoring relative nerve health and the presence of neuropraxia is described. The system utilizes the integration of a waveform function of an elicited or monitored nerve response to provide an indication of the strength of a detected signal from a nerve and thus the relative health and integrity of the nerve. In some embodiments motor nerve stimulation innervates muscle and an EMG waveform is obtained in response thereto. The integration under the waveform is expressed and an indexed value indicating a percentage of a certain threshold value. Methods set forth provide a more reliable status of a nerve in real-time and allow action to be taken to reduce neuropraxia or prevent permanent nerve damage.