The current state of bionic limbs from the surgeon's viewpoint
The current state of bionic limbs from the surgeon's viewpoint
复制标题
DOI：
10.1302/2058-5241.5.180038
复制
发表时间：
2020-02-01
影响因子：
3.4
通讯作者：
Raspopovic, Stanisa
中科院分区：
文献类型：
--
作者：
Bumbasirevic, Marko;Lesic, Aleksandar;Raspopovic, Stanisa
截肢对患者的健康有着毁灭性的影响，随之而来的是心理痛苦、经济损失、难以重新融入社会，以及标准假肢置换的低体现。仿生肢体的主要特点是它们在生物残体和电子设备之间建立了一个界面，不仅提供假肢的运动控制，还提供灵敏的反馈。根据连接的组织类型，仿生肢体可分为三大类：神经-肌肉界面（靶向肌肉神经再支配）、直接肌肉接口和直接神经接口。靶向肌肉神经再支配（TMR）涉及将截肢残端的剩余神经转移到可用肌肉。通过直接肌肉接口，直接肌内植入物记录肌肉收缩，然后通过集成在插座中的线圈无线捕获以驱动假体第三组是使用能够接收来自假体传感器的电信号的可植入电极的残余神经的直接接口。电极植入的手术过程包括瞄准近端神经区域，适当地引入、放置和固定电极和电缆，同时保持手臂/腿和神经的运动，避免过度的神经损伤。仿生肢体的优点是：改善感觉，改善假肢的整合/体现，以及更好的可控性。
Amputations have a devastating impact on patients' health with consequent psychological distress, economic loss, difficult reintegration into society, and often low embodiment of standard prosthetic replacement.The main characteristic of bionic limbs is that they establish an interface between the biological residuum and an electronic device, providing not only motor control of prosthesis but also sensitive feedback.Bionic limbs can be classified into three main groups, according to the type of the tissue interfaced: nerve-transferred muscle interfacing (targeted muscular reinnervation), direct muscle interfacing and direct nerve interfacing.Targeted muscular reinnervation (TMR) involves the transfer of the remaining nerves of the amputated stump to the available muscles.With direct muscle interfacing, direct intramuscular implants record muscular contractions which are then wirelessly captured through a coil integrated in the socket to actuate prosthesis movement.The third group is the direct interfacing of the residual nerves using implantable electrodes that enable reception of electric signals from the prosthetic sensors. This can improve sensation in the phantom limb.The surgical procedure for electrode implantation consists of targeting the proximal nerve area, competently introducing, placing, and fixing the electrodes and cables, while retaining movement of the arm/leg and nerve, and avoiding excessive neural damage.Advantages of bionic limbs are: the improvement of sensation, improved reintegration/embodiment of the artificial limb, and better controllability.