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Abstract
Peripheral nerves are often vulnerable to damage during surgeries, with risks of significant pain, loss of motor function, and reduced quality of life for the patient. Intraoperative methods for monitoring nerve activity are effective, but conventional systems rely on bench-top data acquisition tools with hard–wired connections to electrode leads that must be placed percutaneously inside target muscle tissue. These approaches are time and skill intensive and therefore costly to an extent that precludes their use in many important scenarios. Here we report a soft, skin-mounted monitoring system that measures, stores, and wirelessly transmits electrical signals and physical movement associated with muscle activity, continuously and in real-time during neurosurgical procedures on the peripheral, spinal, and cranial nerves. Surface electromyography and motion measurements can be performed non-invasively in this manner on nearly any muscle location, thereby offering many important advantages in usability and cost, with signal fidelity that matches that of the current clinical standard of care for decision making. These results could significantly improve accessibility of intraoperative monitoring across a broad range of neurosurgical procedures, with associated enhancements in patient outcomes.
Wireless biosensors: easing intraoperative monitoring
A small skin-mounted biosensing device accurately and non-invasively monitors neuromuscular activity in real-time during surgery. With many surgical procedures there is a risk of nerve damage. Although this is often temporary, in some cases it can significantly affect patients’ quality of life. Existing monitoring systems that rely on the accurate placement of needle electrodes into target nerves are cumbersome and expensive. The device developed by a team led by John Rogers, at Northwestern University, and Michel Kliot, at Stanford University, can easily be accommodated to any part of the body to monitor muscle activity in response to nerve impulses and stimulation during surgery. Furthermore, it can wirelessly transmit signals of comparable quality to needle-based systems. These devices could not only increase the use of intraoperative monitoring in hospitals but also contribute to make surgery safer.
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1 University of Illinois at Urbana-Champaign, Department of Materials Science and Engineering, Frederick Seitz Materials Research Laboratory, Urbana, USA (GRID:grid.35403.31) (ISNI:0000 0004 1936 9991)
2 University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, USA (GRID:grid.35403.31) (ISNI:0000 0004 1936 9991)
3 MC10 Inc., Lexington, USA (GRID:grid.450073.5) (ISNI:0000 0004 1796 7138)
4 Northwestern Memorial Hospital, Department of Neurosurgery, Chicago, USA (GRID:grid.416565.5) (ISNI:0000 0001 0491 7842)
5 Tsinghua University, Department of Engineering Mechanics, AML, Center for Mechanics and Materials, Beijing, China (GRID:grid.12527.33) (ISNI:0000 0001 0662 3178); Northwestern University, Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Evanston, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)
6 Stanford University School of Medicine, Department of Neurosurgery, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956)
7 Northwestern University, Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Evanston, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)
8 Northwestern University, Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Evanston, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507); Southeast University, Department of Engineering Mechanics, Nanjing, China (GRID:grid.263826.b) (ISNI:0000 0004 1761 0489)
9 Rehabilitation Institute of Chicago, Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Center for Bionic Medicine, Chicago, USA (GRID:grid.280535.9) (ISNI:0000 0004 0388 0584); Northwestern University, Departments of Physical Medicine & Rehabilitation and Medical Social Sciences, Chicago, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)
10 Northwestern University, Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Evanston, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507); Northwestern University, Center for Bio-Integrated Electronics, Departments of Materials Science and Engineering, Biomedical Engineering, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science, Neurological Surgery, Simpson Querrey Institute for Nano/Biotechnology, McCormick School of Engineering, Feinberg School of Medicine, Evanston, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)
11 MC10 Inc., Lexington, USA (GRID:grid.450073.5) (ISNI:0000 0004 1796 7138); Northwestern University, Center for Bio-Integrated Electronics, Departments of Materials Science and Engineering, Biomedical Engineering, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science, Neurological Surgery, Simpson Querrey Institute for Nano/Biotechnology, McCormick School of Engineering, Feinberg School of Medicine, Evanston, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)
12 Northwestern Memorial Hospital, Department of Neurosurgery, Chicago, USA (GRID:grid.416565.5) (ISNI:0000 0001 0491 7842); Stanford University School of Medicine, Department of Neurosurgery, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956)
13 University of Illinois at Urbana-Champaign, Department of Materials Science and Engineering, Frederick Seitz Materials Research Laboratory, Urbana, USA (GRID:grid.35403.31) (ISNI:0000 0004 1936 9991); Northwestern University, Center for Bio-Integrated Electronics, Departments of Materials Science and Engineering, Biomedical Engineering, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science, Neurological Surgery, Simpson Querrey Institute for Nano/Biotechnology, McCormick School of Engineering, Feinberg School of Medicine, Evanston, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)