Novel Targeted Sensory Reinnervation Technique to Restore Functional Hand Sensation After Transhumeral Amputation
Novel Targeted Sensory Reinnervation Technique to Restore Functional Hand Sensation After Transhumeral Amputation
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DOI：
10.1109/tnsre.2013.2294907
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发表时间：
2014-07-01
影响因子：
4.9
通讯作者：
Chan, K. Ming
中科院分区：
文献类型：
--
作者：
Hebert, Jacqueline S.;Olson, Jaret L.;Chan, K. Ming
我们提出了一个病例研究的一种新的变化，有针对性的感觉神经再支配技术，提供额外的控制感觉恢复后，经肱骨截肢。在正中神经和尺神经的单个神经束上使用术中体感诱发电位，使我们能够专门针对感觉神经束，在离经股截肢者预期运动部位一定距离处重新路由到目标皮神经。这导致了在离散的空间分离的区域中恢复正中神经和尺神经的手绘图。此外，受试者能够使用原生和神经再支配的肌肉部位来控制机器人手臂，同时以生理正确的方式感测来自机器人夹具的触摸和力反馈。这项原理性研究首次证明了在残肢内同时具有双重信息流（运动和感觉）的能力。在致力于临床部署的感觉集成假体装置，这种手术方法解决了重要的问题，恢复一个可用的接入点，以提供自然的手部感觉上肢截肢后。
We present a case study of a novel variation of the targeted sensory reinnervation technique that provides additional control over sensory restoration after transhumeral amputation. The use of intraoperative somatosensory evoked potentials on individual fascicles of the median and ulnar nerves allowed us to specifically target sensory fascicles to reroute to target cutaneous nerves at a distance away from anticipated motor sites in a transhumeral amputee. This resulted in restored handmaps of the median and ulnar nerve in discrete spatially separated areas. In addition, the subject was able to use native and reinnervated muscle sites to control a robotic arm while simultaneously sensing touch and force feedback from the robotic gripper in a physiologically correct manner. This proof of principle study is the first to demonstrate the ability to have simultaneous dual flow of information (motor and sensory) within the residual limb. In working towards clinical deployment of a sensory integrated prosthetic device, this surgical method addresses the important issue of restoring a usable access point to provide natural hand sensation after upper limb amputation.