Development of intraoperative monitoring system for spinal function

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Although computer assisted navigation system are widely used in the treatment of spinal disease in order to minimize the operational damage to the surrounding tissue, the biomechanically spinal joint motion including the degenerative tissue has been insignificantly understood. Instability in the lumbar spinal motion segment (vertebra-disc-vertebra) is noted to be an important factor of spinal disorders. Radiographic or basic biomechanical research for definition of the segmental instability has been well documented. However, some contraversial definitions have been consistently demonstrated.In this project research, to evaluate quantitative spinal mobility and to justify lumber fusion or stabilization, an intraoperative and special designed measurement system has been developed. The system used for measuring spinal segmental mobility is consisted of three segments, spinous process holders, motion generator, and computerized controller. The spinous holders make it possible to handle spinal process without invasiveness for the supra- and inter-spinous ligaments. A continuous displacement that generated from actuator of motion generator at speed of 2.0 mm/s is given to the tip of the spinous processes holders. Measurements of human spinal mobility were made on 24 spinal motion segments in 23 patients with degenerative lumbar disease. (12 men and 11 women) including : 8 segments discopathy, 11 segments spondylitis deformans, 5 segments lumbar spinal canal stenosis. Patient ages ranged from 21 to 83 years (average, 57 years).Each measurement took only about ten minutes on average. Load-displacement curves during spinal segmental motion were recorded with excellent reproducibility. In clinical experiment and conclusion, this system is a accurate tool for measuring intraoperative spinal function. It can be used to evaluate sufficiently the degenerative charasiteristics of spinal segment, and to make pre and post disorder measurements.