CN211985418U

CN211985418U - Electrode for nerve electrophysiology monitoring in spinal and spinal cord operation

Info

Publication number: CN211985418U
Application number: CN202020021673.6U
Authority: CN
Inventors: 乔慧; 陶晓蓉; 樊星
Original assignee: Beijing Neurosurgical Institute
Current assignee: Beijing Neurosurgical Institute
Priority date: 2020-01-06
Filing date: 2020-01-06
Publication date: 2020-11-24
Anticipated expiration: 2030-01-06

Abstract

The utility model discloses an electrode for nerve electrophysiology monitoring in spinal cord operation belongs to medical instrument technical field. The nerve electrophysiology monitoring electrode (1) is provided with an electric insulation base body (2), the base body is provided with an electric conduction piece (3) extending inside the base body, an electrode contact (4) and a connecting lead (5), wherein the electric conduction piece (3) connects the electrode contact (4) with the connecting lead (5), and the tail end of the connecting lead (5) is fixedly connected with a universal joint (51) which can be directly connected with a nerve electrophysiology monitor; the electric insulation substrate (2) is a flexible polymer film with a plane structure or a three-dimensional structure and comprises an electrode area (21) and a turnover area (22) which are integrally formed and connected, the turnover area (22) is not provided with an electrode contact (4), and the turnover area (22) is positioned at one end, close to the connecting lead (5), of the electric insulation substrate (2). The utility model discloses can be used to the detection of the neural signal of telecommunication among the spinal cord operation, do not shelter from the operation field of vision, reduce the neural dysfunction incidence of postoperative.

Description

Electrode for nerve electrophysiology monitoring in spinal and spinal cord operation

Technical Field

The utility model relates to an electrode for nerve electrophysiology monitoring in spinal cord operation belongs to medical instrument technical field.

Background

Spinal cord surgery is often accompanied by a potential risk of spinal cord injury, and the resulting motor dysfunction, particularly paralysis, can place a heavy economic and psychosocial burden on the patient, family, and society. The nerve electrophysiology monitoring in the operation can discover nerve damage generated in the operation as early as possible, and give early warning to an operating doctor so that the operating doctor can take intervention measures in time, thereby relieving or even avoiding the nerve dysfunction after the operation. Therefore, good monitoring techniques and monitoring tools are essential for intraoperative spinal cord monitoring.

The current intraoperative electrophysiological monitoring techniques for spinal cord monitoring include somatosensory evoked potentials (including spinal cord dorsal midline reversal positioning), motor evoked potentials, bulbocavernosal muscle reflex, D-waves, and the like. The dorsal median line reversal positioning of the spinal cord and the D wave monitoring are realized by directly placing electrodes on the spinal cord for monitoring. Compared with other technologies, the method can realize direct monitoring of the spinal cord, the monitoring of the motor function integrity of the spinal cord by the D wave is more specific, the influence of anesthesia is small, and the level of spinal cord injury can be judged by changing the position of the stimulation electrode.

The electrode used for the dorsal midline reversal positioning and D-wave monitoring of the spinal cord at present is shown in figure 1, and comprises an electric insulation base body (2), a plurality of electrode contacts (4) are fixedly connected on the electric insulation base body, and the electrode contacts (4) are connected with a connecting lead (5) through a plurality of electric conducting pieces (3) inside the electric insulation base body. Due to the short distance between the end of the pad insulating base body (2) and the connecting lead (5), when the electrode is used in operation (the electrode contact points are towards the direction of the spinal cord), the connecting lead (5) at the end can be arranged behind the pad insulating base body (2). Because the art field of spinal cord operation is generally less, when carrying out the monitoring of spinal cord electrophysiological signal, the terminal of electrode and connecting lead (5) can cover partial operation region, and this both can influence the effect of monitoring in the art, also can influence the art person's field of vision, extension operation time, increase the risk of operation.

Therefore, it is necessary to develop a special electrode for monitoring in spinal cord surgery.

SUMMERY OF THE UTILITY MODEL

The to-be-solved technical problem of the utility model is: provides an electrode for nerve electrophysiology monitoring, which can be used for spinal cord operation, does not affect the operation visual field and is convenient to use.

In order to achieve the purpose, the utility model adopts the following design scheme.

An electrode (1) for monitoring neuroelectrophysiology in spinal cord operation, which comprises an electric insulation base body (2) and an electric conduction piece (3), an electrode contact (4) and a connecting lead (5) extending in the base body, wherein the electric conduction piece (3) penetrates through the connecting lead (5) and connects the electrode contact (4) with the connecting lead (5), the tail end of the connecting lead (5) is fixedly connected with a universal joint (51) which can be directly connected with a neuroelectrophysiology monitor;

the electric insulation substrate (2) is a flexible polymer film with a plane structure or a three-dimensional structure and comprises an electrode area (21) and a turnover area (22) which are integrally formed and connected, the turnover area (22) is not provided with an electrode contact (4), and the turnover area (22) is positioned at one end, close to the connecting lead (5), of the electric insulation substrate (2).

The design of the turnover area (22) of the electric insulation base body (2) is one of the innovation points of the utility model, and the structure is not the extension of the electrode terminal in the prior art, but is designed for the special use scene, namely the professional requirement of the nerve electrophysiological signal detection in the spinal cord operation. The utility model discloses having combined the exploration and the observation of neurosurgery expert and nerve electrophysiology monitoring expert in the operation practice, this makes its other electrodes that are different from current in essence, can realize not hiding the technological effect in the operation field of vision. In the operation, the area is turned backwards and covered by the operation cloth for fixing, and finally, the nerve electrical signals can be monitored in the operation process by connecting the connecting lead with the main stream electrophysiological monitor under the condition of not blocking the operation visual field. This is for prior art's huge innovation, because at present like the utility model discloses the monitoring of the electrophysiological signal in the operation that does not shelter from the operation field of vision like this is unable to realize, because sheltered from the operation field of vision, has influenced the operation of performing the operation, consequently has few professional at present to monitor the electrophysiological signal in this type of operation.

The length of the electric insulation substrate (2) is 3-10 cm, and the length of the turnover area (22) is 2-5 cm. The length of the folding area needs to meet the requirement that the folding area can be covered and fixed by objects such as an operation towel and the like after being folded, so that the folding area is not too short, and meanwhile, the production cost and the manufacturing difficulty are increased due to too long folding, so that the folding area is better in a proper length range. The width of the insulation substrate is 0.3-1 cm, the width of the turnover area can be the same as that of the electrode area, and the turnover area does not need to directly contact the human spinal cord, so that the turnover area can be larger than that of the electrode area, and the insulation substrate is convenient to hold and fix.

The shape of the electrically insulating matrix (2) is a regular geometric shape and combinations thereof, the regular geometric shape including but not limited to rectangle, ellipse, circle, triangle, pentagon, wedge, trapezoid, etc.; the edge of the electric insulation substrate (2) is a straight line or a curve; the preferred shape is strip shape, i.e. the whole is rectangle, and the four corners are in smooth transition.

The electrode contacts (4) are made of metal, and the number of the electrode contacts is 1-20, preferably 3-6. The most common surgical electrodes of this type are 1 x 6 electrodes, i.e., a single row of 6 electrode contacts. The utility model discloses in can also use the design of 1 x 3 electrode, for 3 electrode contacts of single row constitute, compare the design of a plurality of electrode contacts, reduced the length of electrode self greatly, the convenience is used in spinal cord operation.

The electrode contacts (4) are arranged in a single row or in an array. The electrode contacts (4) are equidistant or non-equidistant. The position of the nerve site to be monitored can be precisely measured and designed to have the respective electrode contacts (4) in the optimal detection position so that the distances between them can be equal or unequal, and in general, equal conditions are more convenient to produce and manufacture.

The shape of the electrode contact (4) is a geometric shape and a combination shape thereof, the geometric shape comprises but is not limited to a circle, an ellipse, a rectangle, a pentagon, a hexagon and the like, and the electrode contact is used for forming an effective contact surface with nerves to carry out the communication of electric signals.

The electric conducting piece (3) is a metal wire or a liquid metal circuit. These technical features and implementations are not known in the prior art, and the use of liquid metal circuitry may provide better flexibility, while the use of metal wires may provide cost advantages.

One or more linear microgrooves (23) are arranged on the back side face of the side, where the electrode contact (4) is located, of the electric insulation base body (2), the direction of each microgroove (23) is perpendicular to the radial direction of the electric insulation base body (2), and two ends of each microgroove are located at the edge position of the turnover area (22). The microgrooves are positioned on the back of the surface where the electrode contacts (4) are positioned, the depth of each microgroove (23) is smaller than the depth from the surface to the electric conducting piece (3), so that the normal use of the electric conducting piece (3) cannot be influenced, meanwhile, the turnover area (22) can be turned backwards more easily, the reverse restoring force of the electric insulating base body (2) can be reduced, the turnover area (22) after turnover is also more easily formed into a plane closer to a human body with the help of the microgrooves, and the cover and the fixation with an operation towel are facilitated.

Each electrode contact (4) is connected with a different connecting lead (5) through an electric conducting piece (3) connected with the electrode contact.

The surface of the electrode contact (4) is provided with a coating or lines, the electric insulation substrate (2) is made of a polymer film material with biocompatibility, and the film material has flexibility and certain hardness.

The coating on the surface of the electrode contact (4) can be any coating capable of improving the detection effect, and the surface lines can be formed in a metal etching mode so as to increase the sensitivity of an electric signal.

The material of the substrate (2) belongs to the prior art, and any material which is conventionally used in the field can be adopted. The matrix material enables the electrode to have certain hardness, and is convenient to be placed along the spinal cord in a pushing mode; meanwhile, the material is soft, the biocompatibility of the material is good, and the spinal cord injury caused by the placement of the electrodes is avoided.

The utility model discloses an ingenious, practical, simple design has changed the application nature of current nerve electrophysiology monitoring electrode completely, through the structure of unique a section of rolling over (22), the operator can be very easily with should roll over a section of rolling over (22) to the direction with operation field of vision opposite direction and roll over, the operation field of vision that makes its the place ahead does not receive sheltering from of electric insulation base member (2) and connecting lead (5) completely to detection and record to the nerve electricity signal of telecommunication in the better realization operation, the security of operation improves. In the prior art, due to the fact that the structure of the turnover area (22) is not provided, the connecting lead (5) partially covers the operation visual field, operation is affected, and therefore monitoring work of nerve electrophysiological signals in the operation is limited.

The utility model has the advantages that: the spinal cord monitoring device has better adaptability with spinal cord surgery, can effectively realize the monitoring of spinal cord electrophysiological signals in the surgery, is easy to place and take out, does not shield the surgical field of vision, and does not occupy the effective operation space of doctors; the electrode substrate material is soft, the biocompatibility of the material is good, the spinal cord injury caused by the placement of the electrode is avoided, and the electrode is convenient to use in spinal cord surgery. The utility model discloses can be arranged in spinal cord dorsal part median reversal location and D ripples monitoring among the spinal cord operation, effectively improve the effect of spinal cord electrophysiology monitoring in the art, reduce spinal cord injury in the art, reduce postoperative nerve dysfunction incidence, make the vast spinal cord disease patient benefit.

Additional aspects and advantages of the invention will be set forth in part in the description which follows and, in part, will be obvious from the description, or may be learned by practice of the invention.

Drawings

The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this application, illustrate embodiment(s) of the invention and together with the description serve to explain the invention without undue limitation to the invention. In the drawings:

FIG. 1 shows a prior art electrode structure diagram

FIG. 2 shows a structure diagram of embodiment 1 of the present invention

FIG. 3 is a view showing a structure of embodiment 2 of the present invention

Figure 4 shows a reference diagram of the use state of the invention

The respective symbols in the figure are as follows: 1-electrode, 2-electric insulation base body, 21-electrode area, 22-turnover area, 23-microgroove, 3-electric conducting piece, 4-electrode contact, 5-connecting lead, 51-universal joint, 6-spinal cord, 61-tumor, 7-dura mater and 8-neuro-electrophysiology instrument.

Detailed Description

In order to make the purpose, technical solution and advantages of the embodiments of the present invention clearer, the drawings of the embodiments of the present invention are combined below to clearly and completely describe the technical solution of the embodiments of the present invention. It is to be understood that the embodiments described are only some of the embodiments of the present invention, and not all of them. All other embodiments, which can be obtained by a person skilled in the art without any inventive work based on the described embodiments of the present invention, belong to the protection scope of the present invention.

In the description of the present invention, it is to be understood that the terms "upper", "lower", "front", "rear", "left", "right", "top", "bottom", "inner", "outer", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of description and simplicity of description, and do not indicate or imply that the device or element referred to must have a particular orientation, be constructed and operated in a particular orientation, and therefore, should not be construed as limiting the present invention.

In the present invention, unless otherwise expressly specified or limited, the terms "mounted," "connected," and "fixed" are to be construed broadly and may, for example, be fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the present invention can be understood according to specific situations by those skilled in the art.

In the present disclosure, unless expressly stated or limited otherwise, the first feature "on" or "under" the second feature may comprise direct contact between the first and second features, or may comprise contact between the first and second features not directly. Also, the first feature being "on," "above" and "over" the second feature includes the first feature being directly on and obliquely above the second feature, or merely indicating that the first feature is at a higher level than the second feature. A first feature being "under," "below," and "beneath" a second feature includes the first feature being directly under and obliquely below the second feature, or simply meaning that the first feature is at a lesser elevation than the second feature.

Unless defined otherwise, technical or scientific terms used herein shall have the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs. The use of "first," "second," and similar terms in the description and in the claims does not indicate any order, quantity, or importance, but rather is used to distinguish one element from another. Also, the use of the terms "a" or "an" and the like do not denote a limitation of quantity, but rather denote the presence of at least one.

Fig. 1 shows an electrode in the prior art, because the back of the substrate is not provided with a turnover area, but a connecting lead is directly arranged at the back of the electrode, the substrate cannot be turned backwards, the connecting lead has certain space and hardness, and can only be forwardly covered at the position of the operation visual field, so that the electrophysiological signal monitoring and the operation cannot be carried out at the same time.

Example 1:

as shown in fig. 2, an electrode (1) for monitoring neuroelectrophysiology in spinal cord operation comprises an electric insulation base body (2) which is provided with an electric conduction piece (3) extending inside the base body, an electrode contact (4) and a connecting lead (5), wherein the electric conduction piece (3) penetrates through the connecting lead (5) and connects the electrode contact (4) with the connecting lead (5), and the tail end of the connecting lead (5) is fixedly connected with a universal joint (51) which can be directly connected with a neuroelectrophysiology monitor;

The shape of the electric insulation base body (2) is strip-shaped, namely the whole body is rectangular, four corners are in smooth transition, the base body is made of a biocompatible silica gel material, and the electric insulation base body has softness and certain hardness, ensures that the electric insulation base body can be smoothly placed into an operation position of a patient and can be conveniently bent backwards, so that the operation visual field is exposed.

The electrode contacts (4) are made of metal, the number of the electrode contacts is 3, the electrode contacts are arranged in a single row, and the distances between the adjacent electrode contacts (4) are equal.

The electrode contact (4) is a circular metal electrode plate, and can be replaced by an electrode plate with any geometric shape.

The electric conducting piece (3) is a metal wire. The connecting lead (5) is made of an electric insulating high polymer material. The electric conducting piece (3) axially penetrates through the connecting lead (5), namely the connecting lead (5) is coated outside the electric conducting piece (3) and covers most of the area.

Each electrode contact (4) corresponds to a different connecting lead (5) through the electric conducting piece (3) connected with the electrode contact.

Example 2:

referring to fig. 3, the difference from embodiment 1 is:

the back side face of the electric insulation base body (2) on one side where the electrode contact (4) is located is provided with a plurality of linear micro grooves (23), the direction of each micro groove (23) is perpendicular to the radial direction of the electric insulation base body (2), and two ends of each micro groove are located at the edge of the turning area (22).

The microgrooves (23) can play a role in guiding the turnover, the reverse resilience force of the electric insulation base body (2) is reduced, and meanwhile, the turnover area after the turnover is convenient to form a plane, so that the turnover area is easier to fix.

The surface of the electrode contact (4) is provided with a coating structure or texture (not shown in the figure, which is prior art).

Example 1 and example 2 conditions of use referring to figure 4, a patient has a tumor (61) on the spinal cord (6) that requires intraoperative resection.

1. The electrode area (21) of the electric insulation base body (2) is inserted into the lower opening of the dura mater (7) of a patient, so that the electrode contact (4) is effectively contacted with the surface of the spinal cord.

2. Then the folding area (22) is folded towards the back (namely the direction opposite to the direction of the operation visual field);

3. the flap (22) can be secured by a surgical drape over the flap (not shown).

4. The universal joint (51) fixedly connected with the tail end of the connecting lead (5) is directly connected to the nerve electrophysiology monitor to realize the monitoring function in the operation.

The above-listed detailed description is only a specific description of a possible embodiment of the present invention, and it is not intended to limit the scope of the present invention, and many other modifications and embodiments can be devised by those skilled in the art, which will fall within the spirit and scope of the principles of this disclosure. More specifically, various variations and modifications are possible in the component parts and/or arrangements of the subject combination arrangement within the scope of the disclosure, the drawings and the appended claims. In addition to variations and modifications in the component parts and/or arrangements, other uses will also be apparent to those skilled in the art.

In short, the above description is only a preferred embodiment of the present invention, and all the equivalent changes and modifications made in accordance with the claims of the present invention should be covered by the scope of the present invention.

Claims

1. An electrode for monitoring nerve electrophysiology in spinal cord operation, which is characterized in that: the nerve electrophysiology monitoring instrument comprises an electric insulation base body (2), wherein the base body is provided with an electric conducting piece (3) extending inside the base body, an electrode contact (4) and a connecting lead (5), the electric conducting piece (3) penetrates through the connecting lead (5) and connects the electrode contact (4) with the connecting lead (5), and the tail end of the connecting lead (5) is fixedly connected with a universal joint (51) which can be directly connected with the nerve electrophysiology monitoring instrument;

2. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 1, wherein: the length of the electric insulation base body (2) is 3-10 cm, and the length of the turnover area (22) is 2-5 cm.

3. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 1, wherein: the shape of the electrically insulating matrix (2) is a regular geometric shape and combinations thereof, the regular geometric shape including but not limited to rectangle, ellipse, circle, triangle, pentagon, wedge, trapezoid, etc.; or the edge of the electric insulation substrate (2) is a straight line or a curve, the shape is a strip shape, the whole body is a rectangle, and the four corners are in smooth transition.

4. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 1, wherein: the electrode contacts (4) are made of metal and the number of the electrode contacts is 1-20.

5. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 4, wherein: the electrode contacts (4) are arranged in a single row or in an array, and the electrode contacts (4) are equidistant or not.

6. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 1, wherein: the shape of the electrode contact (4) is a geometric shape and a combination thereof, and the geometric shape includes but is not limited to a circle, an ellipse, a rectangle, a pentagon and a hexagon.

7. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 1, wherein: the electric conducting piece (3) is a metal wire or a liquid metal circuit.

8. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 1, wherein: one or more linear microgrooves (23) are arranged on the back side face of the side, where the electrode contact (4) is located, of the electric insulation base body (2), the direction of each microgroove (23) is perpendicular to the radial direction of the electric insulation base body (2), and two ends of each microgroove are located at the edge position of the turnover area (22).

9. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 4, wherein: each electrode contact (4) is connected with a different connecting lead (5) through an electric conducting piece (3) connected with the electrode contact.

10. The electrode for nerve electrophysiology monitoring in spinal cord surgery according to claim 1, wherein: the surface of the electrode contact (4) is provided with a coating or grains, the electric insulation substrate (2) is made of a polymer film material with biocompatibility, and the connecting lead (5) is made of an electric insulation high polymer material.