CN102368951A - 电外科手术中的神经监视 - Google Patents
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Abstract
信号处理模块包括输入模块,该输入模块电耦合至神经完整性监视系统(10)的感测探针(52)。探针感测在电外科手术单元(12)的操作期间来自患者的电信号。输入模块从探针接收输入信号。EMG检测模块耦合到输入模块且适配成检测输入信号的状况。根据肌电图活动的能级对状况进行分类。耦合至EMG检测模块的输出模块基于所检测到的状况提供输入信号中的肌电图活动的指示。
Description
背景技术
本公开涉及神经监视系统。更具体地,本发明涉及在电外科手术期间或者在存在来自金属手术仪的伪像的情况下监视神经活动。
电生理学监视辅助外科医生在模糊的手术域内对神经定位,以及在手术期间实时保持并评估神经功能。为此,通常采用神经完整性监视来监视肌电图学(EMG)活动。在神经完整性监视期间,感测电极或记录电极耦合至适当的组织(例如,由感兴趣的神经、外周神经、脊髓、脑干等支配或控制的颅肌)以便感测EMG活动。例如电刺激或机械刺激的刺激可造成组织的激发。在电刺激期间,刺激探针对受验神经可能所处的区域附近施加刺激信号。如果刺激探针接触神经或适度靠近神经,所施加刺激信号通过神经传送来激发受神经支配的组织。在机械刺激中,与适当组织的直接物理接触可造成组织的激发。在任一情形下,相关组织的激发会产生由记录电极(或者其它感测装置)来感测的电脉冲。(诸)记录电极将所感测到的电脉冲信息传递给外科医生以用于在确定EMG活动的背景下的解释。例如,可在显示器上显示和/或以听得见的方式呈现该EMG活动。
神经完整性监视对于包含或涉及神经组织、肌肉组织、或神经性电位记录的众多不同外科手术或评估而言是有用的。例如,各种头颈外科手术要求定位并识别颅神经和外周运动神经。在一些实例中,电外科手术单元用于执行这些外科手术。当前的电外科手术单元包括用作电路中的一个电极的导电尖头或针头,该电路经由耦合至患者的接地电极来接通。通过应用电能源(最常见为射频发生器至尖头)来完成切开组织。一旦尖头被施加到组织,就产生电压梯度,从而在接触点处感生出电流并产生与之关联的热。在电能能级充分高的情况下,所产生的热足以切开组织,且有利地,足以同时灼烧切开的血管组织。
由于由电外科手术单元所产生的电能能级,在电外科手术期间使用时用于神经完整性监视的系统经历大量电干扰。电干扰可产生EMG活动的不正确信号(例如,假阳性)以及将大量噪声引入到神经完整性监视系统中。因此,现有技术涉及在电外科手术期间使用探针来使神经完整性系统的全部信道静噪。因此,在电外科手术单元的操作期间,暂停EMG活动的监视。为了防止外科医生用电外科手术单元切割神经,外科医生将进行短时间的切割,然后停止切割,从而神经完整性监视可被恢复。如果没有检测到EMG活动,则外科医生可进行另一短时间的切割,同时间歇地暂停以恢复神经完整性监视,从而避免切割神经。重复该过程直到外科医生完成该电外科手术。在电外科手术期间不能监视EMG活动的情况下,电外科手术可能变得既麻烦又耗时。
发明内容
本文所呈现的概念涉及信号处理模块、外科手术方法以及神经完整性监视系统。信号处理模块的输入模块电耦合到神经完整性监视系统的感测探针。该探针感测在电外科手术单元操作期间来自患者的电信号。
输入模块从探针接收输入信号。EMG检测模块耦合到输入模块且适配成检测输入信号的状况。根据肌电图活动的能级对状况进行分类。耦合至EMG检测模块的输出模块提供所检测状况的指示。
伪像检测模块还可用来检测输入信号中的伪像状况。伪像检测模块可估计输入信号的功率,从而检测伪像。另外,可包含诸如直流滤波模块和EMG恢复模块等其它模块。
附图简述
图1是包括神经完整性监视系统和电外科手术单元的外科手术环境的示意性框图。
图2是图1的神经完整性监视系统中的信号处理模块的示意性框图。
图3是图1的神经完整性监视系统中用于处理信号的方法的流程图。
图4是用于检测向图1的神经完整性监视系统提供输入的一个或多个信道中的伪像的方法的流程图。
图5是用于从向图1的神经完整性监视系统提供数据的一个或多个信道过滤低频噪声成分的方法的流程图。
图6是用于检测来自向图1的神经完整性监视系统提供输入的一个或多个信道的EMG活动的方法的流程图。
图7是向图1的神经完整性监视系统提供数据的一个或多个信道的EMG信号恢复方法的流程图。
具体实施方式
在图1中示出包括神经完整性监视系统10和电外科手术单元(ESU)12的外科手术环境。一般而言,系统10被配置成辅助并执行人体解剖学的实质上任何神经/肌肉组合的神经完整性监视,以及记录神经电位。系统10包括控制单元20,该控制单元20可采取宽泛的各种形式,且在一个实施例中包括具有监视器32的控制台30以及患者接口模块40。电外科手术单元12包括耦合至手术仪44的ESU发生器42。ESU发生器42生成发送至外科手术仪44的电流以用于切割或者以其它方式处理患者的组织。
系统10包括:刺激探针组件50,其可用于电刺激;以及一个或多个感测探针52,其可以是诸如电极的任何类型的感测装置。控制单元20便于探针组件50的操作,并且处理感测探针52和其它系统10的组件(未示出)在使用期间生成的所有信息。探针组件50和控制单元20适配成允许控制和改变经由设置在探针组件50上的致动器向探针组件50传递的刺激能量,且因此允许控制和改变由探针组件50传递的刺激电平。为此,探针组件50和控制单元20适配成经由操纵探针组件50的致动器来允许刺激能量分一系列分立的、有序的阶段的连续变化(例如递增或递减)。此外,控制单元20处理从感测探针52接收的由所传递刺激引起的信息(例如,患者反应)。
系统10通过使用感测探针52基于所记录的EMG活动来执行监视,该所记录的EMG活动响应于由探针组件50传递的电流能量和/或组织的物理操纵。在图1的一个实施例中,将控制台30和患者接口模块40设置成独立的、通过电缆54通信耦合的部件。替代地,可采用无线链路。此外,可将控制台30和患者接口模块40设置成单个装置。然而,一般而言,患者接口模块40用于促进刺激/感测部件(诸如探针组件50和感测探针52)的简单连接,以及对传入和传出电信号进行管理。控制台30进而进行以下步骤:解释传入信号(由感测探针52所感测的脉冲),显示用户期望的信息,提供听得见的反馈信号,呈现用户界面(如通过包括触摸屏),以及按照来自探针组件50的控制信号向探针组件50传递刺激能量(经由至患者接口模块40的连接),以及按需执行其它任务。
如上所述,患者接口模块40通过电缆54与控制台30传达发给探针组件50的信息和来自探针组件50的信息,以及来自感测探针52的信息。实际上,患者接口模块40用于连接患者(未示出)与控制台30。为此,在一个实施例中,患者接口模块40包括一个或多个(优选8个)感测输入56,诸如电耦合以接收来自感测探针52(图1中大致标示)的信号的一对电极输入。此外,患者接口模块40提供刺激器输入端口58(图1中大致标示)和刺激器输出端口60(图1中大致标示)。刺激器输入端口58从探针组件50接收与期望刺激电平和/或其它活动相关的控制信号,而刺激器输出端口60便于将刺激能量传递给探针组件50。患者接口模块40还可提供诸如接地(或者返回电极)插孔、附加刺激器探针组件的辅助端口等的(多个)附加部件端口。
控制单元20、尤其是控制台30和患者接口模块40在某种意义上与诸如可从美国佛罗里达州杰克逊维尔的Medtronic Xomed购买的NIM-ResponseTM神经完整性监视器的可用监视系统相似。例如,由NIM-ResponseTM神经完整性监视器提供的触摸屏性能可被结合到控制单元20中。然而,此外,系统10采用执行信号处理技术的信号处理模块70,该信号处理模块70对从感测探针52接收的输入信号进行分类并传递与电外科手术单元12操作期间的神经监视相关的输出信号。具体而言,信号处理模块70可在电外科手术单元12的操作期间提供低EMG活动(包括无EMG活动)或者高EMG活动的指示。另外,信号处理模块70可选择性地使从感测探针52向感测输入端口56提供信息的一个或多个信道静噪,阻断所接收信号中的直流(DC)成分或低频噪声并恢复EMG数据。
感测探针52耦合至患者(例如,选定组织)以向信号处理模块70提供信号。在一个实施例中,多个探针52包括电耦合至感测输入56的8个探针。在正常操作中,探针52感测来自患者的电信号并将这些信号发送给信号处理模块70。这些信号包括来自患者组织的、指示患者体中的EMG活动的电脉冲。但是,一些条件可将噪声引入到探针52中,由此破坏向信号处理模块70提供的信号。例如,ESU 12所生成的电流产生由一个或多个探针52检测到的噪声。
多个探针52的每一个构成可在信号处理模块70中独立处理的一单独信道,如下面所论述的。例如,如果总共使用8个感测探针,则可由信号处理模块70独立地处理8个单独信道。为此,信号处理模块70包括对从感测探针52接收的信号进行分类并允许外科医生在电外科手术期间维持监视一个或多个信道的神经活动的部件。分类可以是低能级EMG活动(包括零)或高能级EMG活动。
在一个实施例中,多个探针52的每一个包括例如滤波器72的前端滤波器,其可用于滤除由ESU 12生成的基波频率。替代地,可设置单个前端滤波器以便对从多个感测探针52的每一个接收的信号进行滤波。通过分析ESU 12的操作和/或由ESU 12生成的信号,可确定在ESU 12的操作期间存在哪些成分。在一个实施例中,ESU 12生成29kHz脉冲调制的500kHz射频信号和附加谐波。可调节滤波器72以优化由ESU 12生成的信号的过滤,且因此减少提供给信号处理模块70的噪声。
图2是信号处理模块70的示意性框图,信号处理模块70接收输入信号110并处理这些信号以产生指示输入信号110中的EMG活动能级的输出信号120。输出信号120还可由附加指示来补充,例如伪像检测条件、恢复的EMG信号等。来自感测探针52(图1)的信号通过输入模块122在信号处理模块70中接收。示意性地,输入模块122可将信号与由信号处理模块70内的其它模块所使用的特定探针(即,信道)相关联。另外,输入模块122可包括模数转换器(ADC),其以特定速率采样所接收的信号以便将信号从模拟形式转换成数字形式,如以下更具体论述的。除输入模块122之外,信号处理模块70包括例如向控制台30(图1)提供输出信号120的输出模块124。介于输入模块122和输出模块124之间的是用于检测由输入模块122接收的信号状况并向输出模块124提供对应响应从而能在外科手术期间维持神经完整性监视的多个模块。具体地,信号处理模块70包括伪像检测模块126、直流滤波器模块128、EMG检测模块130以及EMG信号恢复模块132。
图3是由神经完整性监视系统10具体是感测探针52获取的信号的前端处理方法200的流程图。在步骤202,由例如一个或多个探针52的感测探针获取信号。该信号给出ESU数据(由ESU 12的操作引起)以及EMG活动(由来自患者的神经电位引起)两者的指示。在步骤204,滤除ESU数据的基波频率。例如,可由探针52处的滤波器72(图1)来执行该滤波。经滤波的信号则被发送给信号处理模块70的输入模块122。
如上所述,输入模块122包括以采样速率工作以便处理从感测探针52接收的信号的ADC。为了避免混叠,输入模块122在步骤206对来自探针52的信号进行过采样。由于电外科手术单元12生成的噪声具有宽范围的频率,可使用过采样来防止所接收的信号中发生混叠。过采样速率可以比ADC的采样速率大几倍。在一个实施例中,过采样速率可以是采样速率的128倍。在步骤208,可通过使用抽选滤波器将在探针52处感测到的模拟信号转换成数字信号,对信号进行降采样。在步骤210,输出数字信号。在一个示例中,ADC以16kHz的速率采样该信号。如果在步骤206以采样速率的128倍速率或以2.048MHz进行过采样,可在防止频率比1.024MHz低的成分中发生混叠,且在步骤210的数字信号输出中,不会出现比8KHz大的ESU信号。该数字信号可被发送至伪像检测模块126、直流滤波器模块128、EMG检测模块130和/或EMG信号恢复模块132。如下所述,这些模块可处理该数字信号以检测被提供给输出模块124的状况。
图4是用于检测提供给信号处理模块70的一个或多个信道中的伪像的、由伪像检测模块126执行的方法250的流程图。伪像检测模块126可有助于用于检测由接触组织的金属外科手术仪造成的伪像的情形和/或两个或多个外科手术仪相互接触的情形。
当具有不同静电电荷的仪器相互接触或者患者由于电荷达到平衡而造成电流流动时,可产生金属-金属(或金属-患者)伪像。由包含宽带噪声频谱的电火花进行电荷传送,该宽带噪声频谱包括远比EMG高的高频。夜间频率作为不可能是EMG的快速垂直响应显示在监视器上。这经常在需要滤波的同一时间出现在多个信道上。
如果信道的信号可能是伪像,则可与其它信道无关地使该信道静噪,从而避免EMG活动的假阳性指示。在步骤252,由方法200生成的数字信号(图3)从输入模块122被接收到伪像检测模块126中。在步骤254,向具有阻带的数字信号施加高通滤波器,该阻带的范围将EMG数据排斥在外。在一个示例中,确定的EMG活动处于0至3.5kHz的范围中,且因此所施加阻带为0至3.5kHz。所得信号是可进一步处理以确定与该信号相关联的信道是否应被静噪的限带信号。
在步骤256,通过自乘信号并通过样本缓冲器寻找均值来评估限带信号的功率。缓冲器可以是任何大小,且在一个实例中包括80个样本,构成5毫秒数据。在步骤258,可通过平均化无限脉冲响应来对功率评估均值进行过滤。在一个实施例中,该平均可包括50%的老数据和50%的新数据。在步骤260,经过滤的平均值与阈值进行比较。如果需要,可在阈值比较中采用滞后作用。根据比较结果,可在步骤262选择性地使信道静噪(即,抑制)。可向输出模块124输出已检测到伪像的指示。然后可将该指示例如通过监视器32中继给外科医生。因此可避免假阳性,且外科医生不会错误地得到EMG活动的警告。
图5是用于从输入到信号处理模块70的数据滤除直流成分的方法300的流程图。在步骤302,获取由方法200(图3)生成的信号的均值。然后在步骤304使用低通无限脉冲响应滤波器以便滤除信号均值并阻断信号中的直流。一个示例滤波器使用以下等式:
y[n]=x[n]-x[n-1]+ay[n-1],
其中x[n]是输入信号(从数据模块122接收),y[n]是输出信号,而a是常数。如果需要,a的值可被调节成还阻断该信号的低频成分。在应用滤波器之后,阻断该信号的直流成分。然后,在步骤306输出阻断了直流的信号。
图6是被EMG检测模块130所用的用于在噪声(例如由电外科手术引起的噪声)环境内检测EMG活动能级的方法的流程图。为了检测EMG活动能级,利用自协方差法来确定高能级EMG活动的存在性。如果在电外科手术期间检测到高能级EMG活动,可警告外科医生。在352,开始方法350并从方法300(图5)获取信号样本。然后在步骤354估计样本能量。然后在步骤356比较该能级与阈值。基于该比较,在步骤358关于样本是否包含用来指示高能级EMG活动存在的足够能量作出判定。如果探针连接不良或者已从患者组织断开,所得的信号将具有受限能量,且因此将向输出模块124提供低能级EMG活动。
在步骤360计算信号的自协方差。如已知的,自协方差是可基于根据观察值之间的延迟的、信号的随时间偏移的观察值确定的系数。通过EMG数据的分析,已确定了EMG数据是高度相关联的。因此,高度相关联数据可指示高能级EMG活动。在步骤362,可对所有或选定数量的延迟计算自协方差信号的均值。然后在步骤364比较所计算出的均值与阈值。如果均值超过阈值,在步骤366中提供高能级EMG活动存在的指示。
可对方法350进行若干调节以改善稳健性。例如,可向获取的样本施加窗口函数(例如Bartlett窗口),从而减小可能由计算有限数量样本的自协方差系数所引起的末端效应。此外,可利用电平检测器来确定该信号是否接近输入模块122的ADC的电轨(例如,上电压电平或下电压电平)。在该情况下,不会有EMG活动被报告。还可对直流阻断滤波器进行另一调节。例如,该滤波器可制成更积极以衰减低频数据。此外,多个数据缓冲器(例如4个)可用于改善自协方差结果。如果需要,自协方差计算可扩充计算性能。另外,在比较该数据和EMG阈值前,选定系数平方的均值可被用作滤波器输入以便减小噪声和平滑数据。值得注意的是,还可使用其它分类方法。例如,自相关性、小波、S形函数等都可用于将噪声信号分类成包含EMG和/或检测信号中的EMG活动。
图7是在EMG恢复技术中应用自适应滤波器的方法400的流程图。方法400开始于步骤402,在步骤402从输入模块122获取输入信号。在步骤404,向信号施加自适应滤波器以便阻断由ESU 12生成的噪声。滤波器可以是使用各种技术的基于基准的或者是不基于基准的滤波器。一旦滤除由ESU生成的噪声,即在步骤406输出指示EMG活动的信号。
可在方法400中采用各种自适应滤波器和自适应滤波技术。当使用基于基准的滤波器时,感测探针52中的一个可被用于估计输入信号中由电外科手术单元12生成的噪声。来自基准探针的数据被用作至自适应滤波器的噪声估计。例如,最小均方算法、归一化最小均方算法、或递归算法可被用作基于基准的自适应滤波器。这些算法可被调节成改变许多所使用的术语,以及改变如何处理滤波器中的数据以在由电外科手术单元12所生成的噪声信号中恢复EMG数据。
另外,可在方法400中使用不基于基准的自适应算法来恢复EMG数据。示例滤波器包括卡尔曼(Kalman)滤波器和H-无限滤波器。还可按需对这些滤波器进行调节以生成经恢复的EMG信号。
虽然已参考各优选实施例对本公开进行描述,但是本领域的技术人员将认识到可作形式或细节上的改变而不背离本公开的精神和范围。
Claims (41)
1.一种适配成在电外科手术单元的操作期间感测来自患者的电信号和/或外科手术的金属-金属伪像的神经完整性监视系统的信号处理模块,所述信号处理模块包括:
输入模块,其电耦合至感测探针并适配成接收输入信号,所述输入信号指示患者的肌电图(EMG)活动和电外科手术单元的操作;
EMG检测模块,其耦合至所述输入模块并适配成检测所述输入信号中的状况,并根据从所述患者接收的EMG活动能级对所述状况进行分类;以及
输出模块,其耦合至所述EMG检测模块并适配成提供指示所检测状况的输出信号。
2.如权利要求1所述的信号处理模块,其特征在于,进一步包括伪像检测模块,其适配成检测所述输入信号中的伪像并向所述输出模块提供要抑制所述输出信号的指示。
3.如权利要求2所述的信号处理模块,其特征在于,所述伪像基于所述输入信号中的功率估计来检测。
4.如权利要求2所述的信号处理模块,其特征在于,所述伪像基于所述输入信号的频率成分估计来检测。
5.如权利要求2所述的信号处理模块,其特征在于,所述输入模块适配成从多个感测探针接收多个输入信号,且其中所述静噪模块适配成选择性地抑制所述多个输入信号中的至少一个。
6.如权利要求1所述的信号处理模块,其特征在于,还包括直流滤波器模块,其适配成抑制所述输入信号中的低频噪声。
7.如权利要求1所述的信号处理模块,其特征在于,所述EMG检测模块适配成比较所述输入信号中检测到的EMG活动能级与阈值,并向所述输出模块提供所述比较的指示。
8.如权利要求7所述的信号处理模块,其特征在于,所述EMG检测模块估计所述输入信号中的能级以便确定所述EMG活动是否大于能级阈值。
9.如权利要求8所述的信号处理模块,其特征在于,所述EMG检测模块计算所述输入信号的自协方差或自相关性以便检测所述EMG活动能级。
10.如权利要求8所述的信号处理模块,其特征在于,所述EMG检测模块通过使用所述输入信号的多个样本来计算所述输入信号的自协方差或自相关性。
11.如权利要求9所述的信号处理模块,其特征在于,所述EMG检测模块通过使用所述输入信号的多个样本来使用所述输入信号的小波或S形分类函数。
12.如权利要求1所述的信号处理模块,其特征在于,还包括EMG恢复模块,其适配成滤除由所述电外科手术单元生成的噪声并向所述输出模块提供所述患者体中的EMG活动的指示。
13.如权利要求12所述的信号处理模块,其特征在于,所述EMG恢复模块使用基准探针来估计由所述电外科手术单元生成的所述噪声。
14.一种外科手术方法,包括:
将感测探针附连到患者的组织;
紧邻所述探针操作电外科手术单元;
从所述感测探针接收指示所述患者的肌电图(EMG)活动和所述电外科手术单元的操作的输入信号;
根据从所述患者接收的EMG活动能级对从所述探针接收的所述输入信号进行分类;以及
提供指示所述EMG活动能级的输出信号。
15.如权利要求14所述的方法,其特征在于,还包括:检测所述输入信号中的伪像并提供要抑制所述输出信号的指示。
16.如权利要求15所述的方法,其特征在于,基于所述输入信号中的功率估计来检测所述伪像。
17.如权利要求15所述的方法,其特征在于,还包括:
从多个感测探针接收指示所述患者的EMG活动和所述电外科手术单元的操作的多个输入信号;
检测所述输入信号的至少一个输入信号中的伪像;以及
选择性地抑制所述多个输入信号中的至少一个。
18.如权利要求14所述的方法,其特征在于,还包括:
抑制所述输入信号中的直流成分或低频噪声。
19.如权利要求14所述的方法,其特征在于,还包括:
比较所述输入信号中的EMG活动能级与阈值并提供所述比较的指示。
20.如权利要求19所述的方法,其特征在于,还包括:
估计所述输入信号中的能级以便检测所述EMG活动能级是否大于能级阈值。
21.如权利要求20所述的方法,其特征在于,还包括:
计算所述输入信号的自协方差或自相关性以便检测所述EMG活动能级。
22.如权利要求21所述的方法,其特征在于,基于具有极低自协方差或自相关性的高能信号来检测伪像。
23.如权利要求20所述的方法,其特征在于,还包括:
基于小波或S形分类函数将所述输入信号分类成EMG活动。
24.如权利要求21所述的方法,其特征在于,计算所述输入信号的所述自协方差或自相关性包括使用所述输入信号的多个样本。
25.如权利要求14所述的方法,其特征在于,还包括:
滤除由所述电外科所述单元生成的噪声并提供所述患者体中的EMG活动的指示。
26.如权利要求23所述的方法,其特征在于,还包括:
使用基准探针来估计由所述电外科手术单元生成的所述噪声。
27.如权利要求14所述的方法,其特征在于,还包括:
滤除由所述电外科手术单元生成的噪声信号的基波频率。
28.一种在电外科手术单元操作期间使用的神经完整性监视系统,包括:
感测探针,其适配成生成指示所述患者的肌电图(EMG)活动和所述电外科手术单元的操作的输入信号;
输入模块,其电耦合至所述感测探针且适配成接收所述输入信号;
EMG检测模块,其耦合至所述输入模块并适配成检测所述输入信号中的状况,并根据来自所述患者的EMG活动能级对所述状况进行分类;以及
输出模块,其耦合至所述EMG检测模块并适配成提供指示所检测状况的输出信号。
29.如权利要求28所述的神经完整性监视系统,其特征在于,进一步包括伪像检测模块,其适配成检测所述输入信号中的伪像并向所述输出模块提供要抑制所述输出信号的指示。
30.如权利要求29所述的神经完整性监视系统,其特征在于,所述伪像基于所述输入信号中的功率估计来检测。
31.如权利要求29所述的神经完整性监视系统,其特征在于,所述伪像基于所述输入信号中的频率成分估计来检测。
32.如权利要求29所述的神经完整性监视系统,其特征在于,所述输入模块适配成从多个感测探针接收多个输入信号,且其中所述静噪模块适配成选择性地抑制所述多个输入信号中的至少一个。
33.如权利要求28所述的神经完整性监视系统,其特征在于,还包括直流滤波器模块,其适配成抑制所述输入信号中的低频噪声。
34.如权利要求28所述的神经完整性监视系统,其特征在于,所述EMG检测模块适配成比较所述输入信号中检测到的EMG活动能级与阈值并向所述输出模块提供所述比较的指示。
35.如权利要求34所述的神经完整性监视系统,其特征在于,所述EMG检测模块估计所述输入信号中的能级以确定所述EMG活动是否大于能级阈值。
36.如权利要求35所述的神经完整性监视系统,其特征在于,所述EMG检测模块计算所述输入信号的自协方差或自相关性以检测所述EMG活动能级。
37.如权利要求36所述的神经完整性监视系统,其特征在于,所述EMG检测模块通过使用所述输入信号的多个样本来计算所述输入信号的自协方差或自相关性。
38.如权利要求28所述的神经完整性监视系统,其特征在于,还包括EMG恢复模块,其适配成滤除由所述电外科手术单元生成的噪声并向所述输出模块提供所述患者体中的EMG活动的指示。
39.如权利要求38所述的神经完整性监视系统,其特征在于,所述EMG恢复模块使用基准探针来估计由所述电外科手术单元生成的所述噪声。
40.如权利要求28所述的神经完整性监视系统,其特征在于,所述探针包括滤波器,用以滤除由所述电外科手术单元生成的噪声信号的基波频率。
41.如权利要求39所述的神经完整性监视系统,其特征在于,所述EMG恢复模块使用基准探针来消除或滤除由所述电外科手术单元生成的所述噪声。
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EP3181044A1 (en) | 2017-06-21 |
CA2751073C (en) | 2017-09-05 |
KR101634840B1 (ko) | 2016-06-29 |
JP2012516205A (ja) | 2012-07-19 |
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