CN115177272A - System and method for monitoring spinal cord and nerve in intervertebral foramen mirror operation - Google Patents

Abstract

The invention discloses a spinal cord and nerve monitoring system and method in an intervertebral foramen mirror operation. In the system, the myoelectric electrode is used for conducting myoelectric signals of a target; the angle sensor is used for sensing bending angle signals of corresponding joints when a target performs limb movement; the microphone is used for collecting voice information in the operation process and converting the voice information into an analog electric signal; the collector is used for synchronously collecting analog electric signals from the myoelectric electrode, the angle sensor and the microphone in real time, converting the analog electric signals into digital electric signals and further sending the digital electric signals to the processor; the processor analyzes and processes the received digital signals, judges whether the target completes related limb activities according to instructions contained in the voice information, obtains state information of spinal cords and nerves, and displays the state information through the display. The invention can accurately monitor the state of the spinal cord and the nerve in real time without interruption.

Description

System and method for monitoring spinal cord and nerve in intervertebral foramen mirror operation

Technical Field

The invention relates to the technical field of electrophysiological detection, in particular to a spinal cord and nerve monitoring system and method in an intervertebral foramen mirror operation.

Background

The intervertebral foramen mirror operation is an effective treatment means for treating spinal cord diseases such as spinal deformity, spinal stenosis, intervertebral disc protrusion and the like. Compared with open type operations such as the traditional posterior intervertebral fusion, the intervertebral foramen endoscopic operation has the advantages of less bleeding in the operation, small wound, quick recovery after the operation and the like, and obtains more and more extensive clinical application. However, as a minimally invasive surgery, the intervertebral foramen mirror surgery process lacks anatomical landmarks under direct vision, the operation space is relatively narrow, and when the vertebral canal is decompressed or pedicle screws are placed, nerves are easily damaged, so that serious complications are caused.

In order to monitor the state of spinal cord and nerve in operation in real time and avoid nerve injury, technologies such as an arousal test, somatosensory Evoked Potential (SEP), motor Evoked Potential (MEP) and Electromyogram Monitoring (EMG) in operation are mainly adopted at present.

The arousal test judges whether the spinal cord and nerve function of the patient are normal by observing the completion condition of the limb actions of the patient. When the awakening test is implemented, the anesthesia depth needs to be reduced in the operation, after the awakening test is carried out on the patient, whether the patient can complete the related limb activities according to the instructions of a doctor or not is observed, and when the autonomous movement is completed, the anesthesia depth is immediately deepened to complete the operation.

Somatosensory evoked potentials are time-locked potentials evoked by electrical stimulation of peripheral sensory nerves or mixed peripheral nerves. It travels up the greater fibrous somatosensory pathway to the sensory cortex of the brain. In clinical application, according to different monitoring spinal segments and operation requirements, electrical stimulation can be applied to peripheral nerves such as the median nerve of the upper limb or the posterior tibial nerve of the lower limb, corresponding nerve electrophysiological signals are recorded on the nerve trunk and the scalp, and the states of the spinal cord and the nerves are obtained by analyzing signal characteristics.

Motor-evoked potentials are motor-complex potentials recorded at the spinal cord, peripheral nerves, or target muscles by electrically or magnetically stimulating the motor cortex of the brain. The electric potential wave induced by the motor cortex after receiving stimulation descends to the medulla oblongata through the inner capsule, continues to descend to the anterior horn cells of the spinal cord in the lateral cord of the corticospinal cord after the pyramidal crossing, and activates motor neurons to cause the innervated muscle to contract. Corresponding potential changes can be recorded in the epidural space and muscles, and the spinal cord and nerve states can be known by analyzing the change conditions.

Intraoperative electromyography monitoring identifies the status of the associated spinal cord and nerves by collecting and analyzing electromyographic signals of specific muscles. According to different electromyographic signal generation modes, the electromyographic monitoring can be divided into spontaneous electromyographic monitoring and evoked electromyographic monitoring. The former results mainly from nerve root irritation caused by traction or mechanical stimulation during surgery, recording spontaneous myoelectrical activity at the muscles innervated by the nerve root; the spinal cord and nerve state can be judged by electrically stimulating surgical instruments or spinal nerve roots, collecting and analyzing nerve electrophysiological feedback signals of muscles innervated by corresponding nerve roots.

Through analysis, in practical application, the prior art mainly has the following defects.

1) The awakening test is used as a 'gold standard' for monitoring spinal cords and nerves in the operation, and the control condition of the central nerves and the peripheral nerves of the patient on the limb activities can be directly obtained. However, this requires visual or tactile observation by the doctor, and is limited by the clinical experience of the doctor, and may cause erroneous judgment. Moreover, this approach can only be performed at a limited point in time when the patient is awake and does not allow for uninterrupted monitoring of spinal and neurological status in real time.

2) Somatosensory evoked potential, motor evoked potential and intraoperative electromyogram can realize real-time uninterrupted monitoring, but the spinal cord and nerve states are judged by weak nerve electrophysiological signals in the schemes, and the relationship between the normality and abnormality of the signals and the integrity and damage of the spinal cord and the nerves is not strictly corresponding, so that false positive and false negative conditions exist. In addition, these signals are weak in amplitude, typically in the tens of microvolts to a few millivolts, and are easily disturbed by various noise and artifacts during the surgical procedure. For example, the noise and the artifact include 50Hz power frequency interference, stimulation artifact, electromagnetic interference of instruments and equipment, motion artifact of an electrode and a skin interface, and the like, the amplitude can reach hundreds of millivolts, and the existence of the noise and the artifact increases the difficulty of waveform identification and measurement of the neural electrophysiological signals, and influences the accuracy and reliability of spinal cord and neural monitoring.

In summary, the prior art such as the awakening test, the somatosensory evoked potential, the movement evoked potential, the intra-operative electromyogram monitoring and the like used in the intervertebral foramen mirror operation at present have the problems of lack of objective quantitative standard, difficult waveform identification and measurement, and low accuracy and reliability.

Disclosure of Invention

It is an object of the present invention to overcome the above-mentioned deficiencies of the prior art and to provide a system and method for spinal cord and nerve monitoring during transforaminal endoscopic surgery.

According to a first aspect of the present invention, a system for spinal and neurological monitoring during transforaminal endoscopic surgery is provided. The system comprises a myoelectric electrode, an angle sensor, a microphone, a collector, a processor and a display, wherein:

the electromyographic electrode is used for conducting electromyographic signals of a target;

the angle sensor is used for sensing bending angle signals of corresponding joints when a target performs limb movement;

the microphone is used for collecting voice information in the operation process and converting the voice information into an analog electric signal;

the collector is used for synchronously collecting analog electric signals from the myoelectric electrode, the angle sensor and the microphone in real time, converting the analog electric signals into digital electric signals and then sending the digital electric signals to the processor;

and the processor analyzes and processes the received digital signals, judges whether the target completes related limb activities according to instructions contained in the voice information, obtains state information of spinal cords and nerves, and displays the state information through the display.

According to a second aspect of the invention, a method of spinal cord and nerve monitoring during an endoscopic procedure is provided. The method comprises the following steps:

acquiring electromyographic signals of a target, bending angle signals of corresponding joints of the target during limb movement, and acquiring voice instructions of a doctor in the operation process;

and judging whether the target completes the related limb activities according to the voice command, obtaining the state information of the spinal cord and the nerves, and outputting a display result.

Compared with the prior art, the invention has the advantages that the objective quantitative standard for judging the states of the spinal cord and the nerve can be obtained by synchronously acquiring the electromyographic signals, the joint bending angles and the voice data of the patient during limb movement and carrying out combined analysis and correlation judgment on the data, and the states of the spinal cord and the nerve can be accurately monitored in real time without interruption.

Other features of the present invention and advantages thereof will become apparent from the following detailed description of exemplary embodiments thereof, which proceeds with reference to the accompanying drawings.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description, serve to explain the principles of the invention.

FIG. 1 is a block diagram of a spinal cord and nerve monitoring system during an foraminoscopy procedure in accordance with one embodiment of the present invention;

FIG. 2 is a flow chart of a method of monitoring the spinal cord and nerves during an foraminoscopic procedure, according to one embodiment of the present invention;

figure 3 is a schematic diagram of an exemplary limb movement according to one embodiment of the present invention.

Detailed Description

Various exemplary embodiments of the present invention will now be described in detail with reference to the accompanying drawings. It should be noted that: the relative arrangement of the components and steps, the numerical expressions and numerical values set forth in these embodiments do not limit the scope of the present invention unless specifically stated otherwise.

The following description of at least one exemplary embodiment is merely illustrative in nature and is in no way intended to limit the invention, its application, or uses.

Techniques, methods, and apparatus known to those of ordinary skill in the relevant art may not be discussed in detail but are intended to be part of the specification where appropriate.

In all examples shown and discussed herein, any particular value should be construed as merely illustrative, and not limiting. Thus, other examples of the exemplary embodiments may have different values.

It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be discussed further in subsequent figures.

The invention provides a spinal cord and nerve monitoring system in an intervertebral foramen mirror operation, which combines the advantages of the existing awakening test and the electromyogram monitoring technology in the operation. Referring to fig. 1, the system comprises myoelectric electrodes, an angle sensor, a microphone, a collector, a processor, a display and the like.

The myoelectric electrode is used for conducting myoelectric signals, and various types such as an implanted electrode or a surface patch electrode can be used.

The angle sensor is used for sensing the bending angle of the corresponding joint when the target patient performs limb movement under the instruction of the doctor. For example, the angle sensor may be obtained by a displacement sensor formed by a potentiometer through displacement-angle conversion. Or the angle sensor is inconvenient to install and fix, and an Inertial Measurement Unit (IMU) is adopted for replacement.

The microphone is used for collecting voice information in the operation process and converting the voice information into an electric signal. Through the voice command, whether the collected electromyographic signals or joint angle signals of the patient are related to action commands given to the patient by a doctor or not can be judged, and if the collected electromyographic signals or joint angle signals are not related, the collected electromyographic signals or joint angle signals can be noise interference or spontaneous electromyographic signals. The microphone may be an existing commercial microphone.

The collector is used for synchronously collecting analog electric signals from the myoelectric electrode, the angle sensor and the microphone in real time, converting the analog electric signals into digital electric signals and then sending the digital electric signals to the processor.

The processor receives and processes data which are sent by the collector and comprise electromyographic signals, joint angle signals, voice information and the like, performs analysis processing such as digital filtering, feature extraction, electromyographic-joint angle relation measurement and calculation, voice recognition, linear discriminant analysis, data storage and the like on the data, judges whether a patient can complete related limb activities according to doctor instructions, and accordingly obtains state information of spinal cords and nerves. The Processor may be a computer, a System On Chip (SOC), a Digital Signal Processor (DSP), or other device that can implement a specific logic function through user programming.

The display displays the analysis and processing result of the processor, and the state information of the spinal cord and the nerve analyzed by the processor can be obtained from the display so as to prompt a doctor whether to continue the operation.

The system can collect and analyze data such as myoelectricity of a patient, joint bending angle, limb action instructions issued by a doctor to the patient and the like in the process of operation and when a wake-up test is carried out or not carried out so as to realize spinal cord and nerve monitoring. Referring to fig. 2, the monitoring method for spinal cord and nerve includes the following steps.

Step S201, attaching an electrode, mounting an angle sensor, and a microphone.

Firstly, before an operation, a myoelectric electrode is pasted on a patient, an angle sensor is installed, and a microphone for acquiring a doctor voice instruction is arranged.

According to the difference of the depth of the monitored muscle position, the myoelectric electrode can use an implanted electrode such as a needle electrode, and can also use a surface patch type electrode such as a silver/silver chloride gel electrode. The surface patch type electrode is used for collecting surface electromyogram signals, and the implanted type electrode is used for collecting deep electromyogram signals. The myoelectric electrode is pasted on the spinal cord to be monitored or the muscle which is innervated by nerves and controls the limb movement or the corresponding skin, and the pasting positions of the limbs at the two sides are symmetrical. For example, if monitoring of the L3/L4 segment of the spine is desired, it may be placed in the lateral femoris muscles of both legs; if monitoring of the L4/L5 segment of the spine is required, the monitoring device can be placed on tibialis anterior muscles of both legs.

The angle sensor is arranged at a movable joint corresponding to the limb movement of a patient and used for measuring the bending angle of the joint, and the installation positions of limbs on two sides are symmetrical.

Step S202, the patient completes preset limb monitoring actions in the operation according to different joint bending angles, and corresponding myoelectricity and joint angle data are collected.

After the sensors are adhered and installed, the patient is guided to complete the preset limb monitoring action in the operation at different joint bending angles, and corresponding electromyographic signals and joint angle data are synchronously acquired. For example, a typical limb movement is shown in fig. 3, and may be a leg raising, toe raising, etc. corresponding to the spinal nerves to be monitored. The different bending angles of the joints and the different electromyographic signals are also different, and various (such as 3-5) electromyographic data under different bending angles can be recorded, but the electromyographic data under the maximum angle is included.

Step S203, analyzing the electromyographic data, extracting the characteristics and establishing a model for predicting the joint angle by using the electromyography.

The electromyographic data is filtered, for example, by using a digital filter such as high-pass filtering or power frequency notch to remove interference such as zero drift and power frequency noise. And extracting the characteristics of time-frequency domain data related to joint angles, such as root mean square values, integral values, absolute average values, average power frequencies and the like, in the filtered electromyographic data. The method comprises the steps of using common models such as linear discriminant analysis and back propagation neural networks, taking time-frequency domain features corresponding to electromyographic signals as input, taking joint bending angles as output, and establishing a model (also called an electromyographic joint angle prediction model) for predicting joint angles. And training the model by using the collected myoelectricity and joint angle sample data to obtain model parameters such as weight, bias and the like.

And step S204, starting the operation, synchronously acquiring myoelectricity, joint angle and voice data in real time, and identifying the limb action instruction given by the doctor.

After the model training is finished, the intervertebral foramen mirror operation is started, general or local anesthesia can be performed according to the operation requirement, but a proper anesthetic drug is selected to avoid the influence on the electromyographic signals of the muscles innervated by the monitored nerves. In the operation process, the system of fig. 1 is used for synchronously and uninterruptedly acquiring myoelectricity, joint angles and voice data in real time, and carrying out preprocessing such as filtering on the data. The doctor selects to wake up (general anesthesia) or not (local anesthesia) the patient according to the operation progress and the monitoring requirement, and instructs the patient to complete the preset monitoring limb action in the operation, and the patient should be instructed to complete the action instruction by the maximum bending angle or the maximum force for accurately monitoring the state of the spinal cord and the nerve.

Step S205, judge whether the body movement order has been given.

And performing real-time online recognition on the voice data, and analyzing whether a doctor gives an action instruction to a patient.

And S206, analyzing and calculating the issued electromyographic characteristics and joint angle data, and calculating the difference value of the corresponding data of the patient before the operation.

If the doctor is detected to issue the relevant instruction, analyzing and calculating the electromyographic signal characteristic and the maximum joint bending angle after the instruction is issued, and calculating the difference value between the electromyographic signal characteristic or the maximum joint bending angle and the corresponding data of the patient before the operation. Meanwhile, the myoelectricity data after giving the instruction and a myoelectricity-joint angle prediction model established before the operation are used for predicting the joint bending angle and calculating the difference between the myoelectricity data and the actual value.

The obtained difference may include an electromyographic signal characteristic difference, a difference between maximum joint angles before and after an operation, or an overshoot between the collected joint bending angle and the model-based predicted joint bending angle. The subsequent judgment by using the difference values can be set according to actual needs.

Step 207, determining whether the difference exceeds a set threshold.

If the difference values are all within the preset threshold range (S211), the normal functions of the spinal cord and the nerve of the patient are indicated, and a corresponding result is given on a display screen to prompt the doctor to perform the operation normally (step S212).

If the difference values exceed the preset threshold range, indicating that the patient has spinal cord or nerve injury, giving an alarm on the display screen to prompt the doctor to stop the operation (step S208); if only partial data exceeds the threshold value, the analysis is carried out according to the results of the joint angle prediction by myoelectricity, if the difference between the predicted angle and the actual angle is within the allowable error (such as 5 degrees) of the model, the normal functions of the spinal cord and the nerve of the patient are indicated, the maximum bending angle cannot be reached possibly due to anesthesia and the like, the action can be continued after the patient tries to rest for a period of time, and otherwise, the abnormal functions of the spinal cord and the nerve of the patient are indicated.

During the operation, even if the limb action command given by the doctor is not detected (step S209), the myoelectricity and the joint bending angle data are collected in real time without interruption. It is detected whether or not the electromyogram data characteristic or the joint angle exceeds a threshold value set in advance (for example, 20% of a corresponding value when the root mean square value of the electromyogram exceeds the maximum bending angle in a time window of 200ms, or the joint bending angle is more than 15 °). If so, after the interference conditions such as the autonomous activity of the patient, the external noise and the like are eliminated, if the abnormal data condition still does not disappear, the traction or mechanical stimulation to the nerve root possibly exists in the operation process is prompted, at the moment, the doctor should stop the operation, the patient is issued with the limb monitoring action instruction in the operation (step S210), and meanwhile, the acquisition, analysis and judgment are carried out on the relevant data after the instruction is issued.

Normal and abnormal data before and during the operation are stored and analyzed, and according to the results of myoelectric data characteristics, big data analysis, doctor judgment and the like, a threshold judgment standard is optimized and perfected, and the accuracy and reliability of spinal cord and nerve monitoring are continuously improved (step S213).

In summary, compared with the prior art, the invention has the following advantages:

1) As an improvement of a 'gold standard' -awakening test for monitoring spinal cords and nerves in the existing operation, the invention provides an objective quantitative standard for judging the states of the spinal cords and the nerves by synchronously acquiring data such as myoelectricity, joint bending angles, voice and the like in real time and carrying out online analysis and correlation judgment on the data, thereby avoiding misjudgment caused by the conditions of inaccurate visual or touch judgment, insufficient clinical experience of doctors and the like and improving the accuracy and reliability of monitoring in the operation. In addition, the problem that the states of the spinal cord and the nerve cannot be uninterruptedly monitored in real time in the conventional awakening test is solved.

2) The invention improves the anti-interference capability of the monitoring system in the operation by collecting and analyzing the multi-modal physiological data such as myoelectricity, joint angle, voice and the like, and avoids the problems of difficult waveform identification and measurement and poor anti-interference capability caused by the fact that the existing somatosensory evoked potential, motion evoked potential and electromyography in the operation simply collect weak nerve electricity or electromyography signals.

3) The invention collects the preoperative patient data, establishes a model for predicting the joint bending angle by using myoelectricity, applies the model to the estimation of the joint bending angle in the operation process, judges the states of spinal cords and nerves according to the model, and reduces the false positive rate of the judgment result.

4) According to the invention, normal and abnormal data before and during the operation are stored and analyzed, and according to the results of myoelectric data characteristics, big data analysis, doctor judgment and the like, the threshold judgment standard is optimized and perfected, so that the accuracy and reliability of spinal cord and nerve monitoring can be continuously improved. Through full simulation test verification, the invention can meet clinical requirements and give more accurate clinical indication.

The present invention may be a system, method and/or computer program product. The computer program product may include a computer-readable storage medium having computer-readable program instructions embodied therewith for causing a processor to implement various aspects of the present invention.

The computer-readable storage medium may be a tangible device that can hold and store the instructions for use by the instruction execution device. The computer readable storage medium may be, for example, but not limited to, an electronic memory device, a magnetic memory device, an optical memory device, an electromagnetic memory device, a semiconductor memory device, or any suitable combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following: a portable computer diskette, a hard disk, a Random Access Memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), a Static Random Access Memory (SRAM), a portable compact disc read-only memory (CD-ROM), a Digital Versatile Disc (DVD), a memory stick, a floppy disk, a mechanical coding device, such as a punch card or an in-groove protruding structure with instructions stored thereon, and any suitable combination of the foregoing. Computer-readable storage media as used herein is not to be construed as transitory signals per se, such as radio waves or other freely propagating electromagnetic waves, electromagnetic waves propagating through a waveguide or other transmission medium (e.g., optical pulses through a fiber optic cable), or electrical signals transmitted through electrical wires.

The computer-readable program instructions described herein may be downloaded from a computer-readable storage medium to a respective computing/processing device, or to an external computer or external storage device via a network, such as the internet, a local area network, a wide area network, and/or a wireless network. The network may include copper transmission cables, fiber optic transmission, wireless transmission, routers, firewalls, switches, gateway computers and/or edge servers. The network adapter card or network interface in each computing/processing device receives computer-readable program instructions from the network and forwards the computer-readable program instructions for storage in a computer-readable storage medium in the respective computing/processing device.

The computer program instructions for carrying out operations of the present invention may be assembler instructions, instruction Set Architecture (ISA) instructions, machine-related instructions, microcode, firmware instructions, state setting data, or source code or object code written in any combination of one or more programming languages, including an object oriented programming language such as Smalltalk, C + +, python, or the like, and conventional procedural programming languages, such as the "C" programming language or similar programming languages. The computer-readable program instructions may execute entirely on the user's computer, partly on the user's computer, as a stand-alone software package, partly on the user's computer and partly on a remote computer or entirely on the remote computer or server. In the case of a remote computer, the remote computer may be connected to the user's computer through any type of network, including a Local Area Network (LAN) or a Wide Area Network (WAN), or the connection may be made to an external computer (for example, through the Internet using an Internet service provider). In some embodiments, aspects of the present invention are implemented by personalizing an electronic circuit, such as a programmable logic circuit, a Field Programmable Gate Array (FPGA), or a Programmable Logic Array (PLA), with state information of computer-readable program instructions, which can execute the computer-readable program instructions.

Aspects of the present invention are described herein with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems) and computer program products according to embodiments of the invention. It will be understood that each block of the flowchart illustrations and/or block diagrams, and combinations of blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer readable program instructions.

These computer-readable program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks. These computer-readable program instructions may also be stored in a computer-readable storage medium that can direct a computer, programmable data processing apparatus, and/or other devices to function in a particular manner, such that the computer-readable medium storing the instructions comprises an article of manufacture including instructions which implement the function/act specified in the flowchart and/or block diagram block or blocks.

The computer readable program instructions may also be loaded onto a computer, other programmable data processing apparatus, or other devices to cause a series of operational steps to be performed on the computer, other programmable apparatus or other devices to produce a computer implemented process such that the instructions which execute on the computer, other programmable apparatus or other devices implement the functions/acts specified in the flowchart and/or block diagram block or blocks.

The flowchart and block diagrams in the figures illustrate the architecture, functionality, and operation of possible implementations of systems, methods and computer program products according to various embodiments of the present invention. In this regard, each block in the flowchart or block diagrams may represent a module, segment, or portion of instructions, which comprises one or more executable instructions for implementing the specified logical function(s). In some alternative implementations, the functions noted in the block may occur out of the order noted in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. It will also be noted that each block of the block diagrams and/or flowchart illustration, and combinations of blocks in the block diagrams and/or flowchart illustration, can be implemented by special purpose hardware-based systems which perform the specified functions or acts, or combinations of special purpose hardware and computer instructions. It is well known to those skilled in the art that implementation by hardware, by software, and by a combination of software and hardware are equivalent.

Having described embodiments of the present invention, the foregoing description is intended to be exemplary, not exhaustive, and not limited to the embodiments disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the described embodiments. The terminology used herein is chosen in order to best explain the principles of the embodiments, the practical application, or improvements made to the technology in the marketplace, or to enable others of ordinary skill in the art to understand the embodiments disclosed herein. The scope of the invention is defined by the appended claims.

Claims (10)

1. A spinal cord and nerve monitoring system in an intervertebral foramen mirror operation comprises a myoelectric electrode, an angle sensor, a microphone, a collector, a processor and a display, wherein:

the electromyographic electrode is used for conducting electromyographic signals of a target;

the angle sensor is used for sensing bending angle signals of corresponding joints when a target performs limb movement;

the microphone is used for collecting voice information in the operation process and converting the voice information into an analog electric signal;

the collector is used for synchronously collecting analog electric signals from the myoelectric electrode, the angle sensor and the microphone in real time, converting the analog electric signals into digital electric signals and then sending the digital electric signals to the processor;

and the processor analyzes and processes the received digital signals, judges whether the target completes related limb activities according to instructions contained in the voice information, obtains state information of spinal cords and nerves, and displays the state information through the display.

2. The system of claim 1, wherein the myoelectric electrode is an implantable electrode or a surface patch electrode.

3. The system according to claim 1, wherein the angle sensor is obtained by displacement-angle transformation of a displacement sensor consisting of a potentiometer or by using an inertial measurement unit.

4. The system of claim 1, wherein the processor is a computer, a system-on-a-chip, or a digital signal processor.

5. The system of claim 1, wherein the processor obtains status information of the spinal cord and nerves according to the following steps:

if the doctor is detected to issue a relevant instruction according to the voice information, acquiring myoelectric characteristics and joint bending angles after the instruction is issued;

inputting the electromyographic characteristics after giving the instruction into a trained joint angle prediction model, predicting a joint bending angle, and calculating a difference value between the actual joint bending angle and the collected actual joint bending angle;

if the corresponding difference values under all the instructions are within the set threshold range, prompting the doctor to normally perform the operation through the display;

if the corresponding difference value under all the instructions exceeds the threshold range, prompting the doctor to stop the operation through the display;

if some of the corresponding difference values under all the instructions exceed the threshold range, analyzing according to the prediction result of the joint angle prediction model, and if the difference between the predicted joint bending angle and the actual joint bending angle is within the set allowable error range, prompting to continue completing the action after a period of time through the display.

6. The system of claim 5, wherein the joint angle prediction model is trained according to the following steps:

collecting electromyographic signals of various limb activities for filtering to filter interference;

extracting time-frequency domain characteristics related to joint angles aiming at the filtered myoelectric signals, and constructing a sample data set, wherein each sample reflects the corresponding relation between the time-frequency domain characteristics of the myoelectric signals and the joint bending angles;

and establishing a joint angle prediction model, taking the time-frequency domain characteristics corresponding to the electromyographic signals as input, taking the bending angle of the joint as output, and training by using the sample data set to obtain model parameters.

7. The system of claim 5, wherein the joint angle prediction model is a linear discriminant analysis model or a neural network model.

8. The system of claim 5, wherein during a surgical procedure, the processor further performs the steps of:

under the condition that voice information is not detected, detecting whether the data characteristic or the joint bending angle of the electromyographic signal exceeds a set threshold value or not so as to judge whether an abnormal condition occurs or not;

and under the condition that the abnormal condition is judged to occur, after the target autonomous activity or the external noise interference condition is eliminated, if the abnormal condition still does not disappear, prompting the doctor to stop the operation through the display.

9. A method of spinal cord and nerve monitoring during an foraminoscopic procedure based on the system of any one of claims 1 to 8, comprising the steps of:

acquiring electromyographic signals of a target and bending angle signals of corresponding joints of the target during limb movement, and acquiring voice instructions of doctors in the operation process;

and judging whether the target completes the related limb activities according to the voice command, obtaining the state information of the spinal cord and the nerve, and outputting and displaying.

10. A computer-readable storage medium, on which a computer program is stored which, when being executed by a processor, carries out the steps of the method as claimed in claim 9.

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