KR102655437B1 - Neuromonitoring apparatus and method - Google Patents

Abstract

The present invention relates to a neural monitoring device and a control method thereof. A neural monitoring device according to an embodiment of the present invention, comprising: a communication module for transmitting and receiving at least one information or data to at least one manager terminal; a stimulation application module that applies a preset stimulation signal to each electrode attached to at least one part of the patient; a detection module that detects and amplifies at least one of a motor-evoked potential and a somatosensory-evoked potential generated by a stimulus signal applied to each electrode; a processing module that converts at least one of the amplified motor evoked potential and the amplified somatosensory evoked potential into a digital signal and removes a noise signal to generate each monitoring signal; a generation module that checks for abnormalities in the patient based on the generated monitoring signal and generates a monitoring cycle for at least one part; a storage module that stores various data or information and at least one process necessary to monitor the patient's nerves; and a control module that performs an operation to monitor the nerves of the patient based on the at least one process, wherein the control module is configured to, when an examination mode is set by an input signal from the outside, monitor at least one nerve of the patient. By checking the motor evoked potential and somatosensory evoked potential for each part through each electrode attached to one part to check for abnormalities, the monitoring cycle is set for each part, and the monitoring mode is activated by an input signal from the outside. Once set, based on the set monitoring cycle for each part, the somatosensory evoked potential for each part can be checked through an electrode attached to at least one part of the patient to check for abnormalities.

Description

NEUROMONITORING APPARATUS AND METHOD}

The present invention relates to a neural monitoring device and a control method thereof, and more specifically, to a neural monitoring device and a control method capable of continuously monitoring the patient's nerves in an awake state.

In general, a neuromonitoring device is a system that provides real-time information on the patient's neurophysiological changes during nerve-related surgery, and is an essential equipment for spinal disease, cerebrovascular disease, and brain tumor surgery.

Many university hospitals and specialty hospitals have already purchased or are planning to purchase, and in the United States, neuromonitoring devices are strongly recommended during nerve-related surgeries. This neuromonitoring device monitors 12 cranial nerves and performs a variety of functions, including motor evoked potentials (MEP), somatosensory evoked potentials (SSEP), auditory evoked potentials (AEP), electromyography (EMG), electrocorticography (ECOG), and electroencephalogram (EEG). can do. Through this, if any abnormal reaction occurs in the nervous system or sensory system during surgery, it is immediately fed back to the surgeon, helping to decide whether to proceed with the surgery or not, which is very useful in minimizing postoperative complications.

From the perspective of a clinician who operates and treats actual patients, the need for a neuromonitoring system even after surgery is urgently felt. In addition, if nerve tissue is compressed due to edema or hematoma after surgery, nerve paralysis may progress or consciousness may deteriorate. In some cases, the medical staff quickly detects this and takes appropriate measures, but it is discovered by the patient's family or is already in neurological condition. If discovered in a worsening condition, there is a high possibility of permanent neurological deficits. Recently, as medical disputes due to these issues have increased, there has been a problem of non-medical expenditures and social waste.

Therefore, by analyzing clinical information on neuromonitoring during surgery and identifying the relationship with disease, lesion location, and neurological status, it is possible to suggest possible scale and range upon awakening, and through this, the patient's condition in the awake state can be presented. Technologies that enable continuous neural monitoring need to be developed.

Korean Patent Publication No. 10-2018-0125236 (Publication date: November 23, 2018)

The present invention was proposed to solve the problems described above. By analyzing clinical information on neuromonitoring during surgery and identifying relationships with diseases, lesion locations, and neurological conditions, the possible scale and range at the time of awakening are determined. It is possible to present a neural monitoring device and a control method thereof that enable continuous neural monitoring of a patient in an awake state.

The problems to be solved by the present invention are not limited to the problems mentioned above, and other problems not mentioned can be clearly understood by those skilled in the art from the description below.

A neural monitoring device according to an embodiment of the present invention for solving the above-mentioned problems includes a stimulation application module that applies a preset stimulation signal to an electrode attached to at least one body part of a patient; a processing module that generates a monitoring signal for the evoked potential generated and detected by the stimulation signal; a generation module that compares the generated monitoring signal with a preset reference signal to check whether there is an abnormality in the patient, and generates a monitoring cycle for each of the at least one body part based on the confirmation result; and a control module that performs operations to monitor the patient's nerves.

In addition, the control module controls the processing module to generate monitoring signals for motor evoked potentials and somatosensory evoked potentials when the patient is undergoing surgery, and when the patient is after surgery, based on the generated monitoring cycle. A specific stimulation signal can be applied to one of the electrodes attached to the sensory nervous system, and the processing module can be controlled to generate a monitoring signal for the somatosensory evoked potential generated and detected by the specific stimulation signal.

Additionally, it may include a first electrode attached to the patient's motor nervous system and a second electrode attached to the sensory nervous system.

Additionally, a detection module that detects and amplifies the evoked potential; The processing module may generate the monitoring signal by converting the evoked potential amplified by the detection module into a digital signal and removing the noise signal.

In addition, the monitoring signal is characterized as a combined variable used to determine the state of the patient's nervous system during or after surgery.

In addition, the processing module extracts the occurrence time of the peaks of the evoked potential and the amplitude of the peaks from the evoked potential, and generates the monitoring signal based on the ratio of the amplitude to the occurrence time of the peaks. You can.

In addition, the control module compares the waveform of the generated monitoring signal with the corresponding reference waveform to determine whether there is an abnormality in the patient, and the neural monitoring device has a storage module in which the reference waveform preset for each part is stored. More may be included.

Additionally, the control module may control the monitoring period generated for the specific body part to be changed to a shorter cycle when an abnormal reaction exists in the evoked potential measured from a specific body part of the patient.

Meanwhile, a control method for performing a neural monitoring device according to an embodiment of the present invention is a method performed by a neural monitoring device, and includes applying a preset stimulation signal to an electrode attached to at least one body part of a patient. step; generating a monitoring signal for an evoked potential generated and detected by the stimulus signal; and comparing the generated monitoring signal with a preset reference signal to determine whether there is an abnormality in the patient, and generating a monitoring cycle for each of the at least one body part based on the confirmation result.

Other specific details of the invention are included in the detailed description and drawings.

According to the present invention, by analyzing clinical information on neural monitoring during surgery and identifying the relationship with each disease, lesion location, and neurological condition, it is possible to present a possible scale and range at the time of awakening, and through this, the awakened state can be presented. Enables continuous neuromonitoring of the patient.

The effects of the present invention are not limited to the effects mentioned above, and other effects not mentioned will be clearly understood by those skilled in the art from the description below.

1 is a diagram showing the network structure of a neural monitoring system according to an embodiment of the present invention.
Figure 2 is a diagram showing the configuration of a neural monitoring device according to an embodiment of the present invention.
Figure 3 is a flowchart showing a control method for performing a neural monitoring device according to an embodiment of the present invention.
Figure 4 is a diagram showing an example of test information displayed through a display unit of a neural monitoring device in a neural monitoring system according to an embodiment of the present invention.
Figures 5A to 5C are diagrams showing an example of monitoring information displayed through a display unit of an administrator terminal in a neural monitoring system according to an embodiment of the present invention.

The advantages and features of the present invention and methods for achieving them will become clear by referring to the embodiments described in detail below along with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below and may be implemented in various different forms. The present embodiments are merely provided to ensure that the disclosure of the present invention is complete and to provide a general understanding of the technical field to which the present invention pertains. It is provided to fully inform the skilled person of the scope of the present invention, and the present invention is only defined by the scope of the claims.

The terminology used herein is for describing embodiments and is not intended to limit the invention. As used herein, singular forms also include plural forms, unless specifically stated otherwise in the context. As used in the specification, “comprises” and/or “comprising” does not exclude the presence or addition of one or more other elements in addition to the mentioned elements. Like reference numerals refer to like elements throughout the specification, and “and/or” includes each and every combination of one or more of the referenced elements. Although “first”, “second”, etc. are used to describe various components, these components are of course not limited by these terms. These terms are merely used to distinguish one component from another. Therefore, it goes without saying that the first component mentioned below may also be a second component within the technical spirit of the present invention.

Unless otherwise defined, all terms (including technical and scientific terms) used in this specification may be used with meanings commonly understood by those skilled in the art to which the present invention pertains. Additionally, terms defined in commonly used dictionaries are not interpreted ideally or excessively unless clearly specifically defined.

Spatially relative terms such as “below”, “beneath”, “lower”, “above”, “upper”, etc. are used as a single term as shown in the drawing. It can be used to easily describe the correlation between a component and other components. Spatially relative terms should be understood as terms that include different directions of components during use or operation in addition to the directions shown in the drawings. For example, if a component shown in a drawing is flipped over, a component described as “below” or “beneath” another component will be placed “above” the other component. You can. Accordingly, the illustrative term “down” may include both downward and upward directions. Components can also be oriented in other directions, so spatially relative terms can be interpreted according to orientation.

As used in the specification, the term “unit” or “module” refers to a hardware component such as software, FPGA, or ASIC, and the “unit” or “module” performs certain roles. However, “part” or “module” is not limited to software or hardware. A “unit” or “module” may be configured to reside on an addressable storage medium and may be configured to run on one or more processors. Thus, as an example, a “part” or “module” refers to components such as software components, object-oriented software components, class components, and task components, processes, functions, properties, Includes procedures, subroutines, segments of program code, drivers, firmware, microcode, circuits, data, databases, data structures, tables, arrays, and variables. The functionality provided within components and “parts” or “modules” can be combined into smaller components and “parts” or “modules” or into additional components and “parts” or “modules”. Could be further separated.

Unless otherwise defined, all terms (including technical and scientific terms) used in this specification may be used with meanings commonly understood by those skilled in the art to which the present invention pertains. Additionally, terms defined in commonly used dictionaries are not interpreted ideally or excessively unless clearly specifically defined.

Intraoperative neurophysiological monitoring (INM) is a method of performing neurophysiological tests to prevent nervous system damage during surgery. Among these, motor evoked potential (MEP) and somatosensory evoked potential (SSEP) tests are most commonly used in most INMs.

At this time, management of electrical cords and wires is important due to the nature of the operating room where many machines are located in a small space. Incorrectly positioned electrodes not only provide incorrect information, but also pressure ulcers can occur due to electrodes located in pressed areas, so INM must be performed by determining the correct electrode location. do.

Here, the motor evoked potential test stimulates the brain motor pathway through stimulation electrodes installed on the scalp and records muscle responses through recording electrodes installed on both arms (thumb and little finger abductors) and both legs (tibialis anterior and great toe abductors). It is a test that records in waveforms, and motor evoked potentials indicate the level of activity of the overall motor nervous system connected to the cerebral cortex and cerebrospinal tract. In other words, when magnetic stimulation directly or indirectly excites several cerebrospinal tracts connected to the cerebral motor cortex, the excitement of the stimulated cerebrospinal tract is a potential that occurs when the terminal muscles contract through alpha motor neurons in the corresponding spinal cord. 8 Therefore, motor evoked potentials are related to the excitability of the cerebral cortex, and if motor evoked potentials are not induced during appropriate magnetic stimulation, it means that the nerve cells or nerve stems are dead or have a very high motor threshold.

Meanwhile, the somatosensory evoked potential test is a test that stimulates the median nerve in the wrist area and the posterior tibial nerve in the ankle area and records the response of the sensory area as a waveform through a recording electrode installed on the scalp. There are several methods of INM. It is one of the most used methods. This evaluates the sensory nervous system, but because the locations of the motor and sensory nervous systems are often close together, it is used not only to evaluate the sensory nervous system but also to detect changes in the motor nervous system. SSEP is widely used because it can be measured more frequently than MEP, waveforms can be obtained stably, and it is helpful in evaluating the location of the lesion.

The present invention is basically intended to test the cortical area responsible for the brain's motor system through motor evoked potentials, but since it is difficult to perform such a test after surgery, the motor system is indirectly tested by testing the sensory cortex through a somatic evoked test. The purpose is to perform a cortical examination that is responsible for. As explained earlier, this takes advantage of the close proximity of the motor nervous system and the sensory nervous system.

For this purpose, the present invention performs a motor evoked potential test and a somatosensory evoked potentials test during surgery, sets a monitoring cycle based on the performance results, and monitors the patient at each set cycle after surgery. Carry out surveillance on Furthermore, the monitoring information is transmitted to at least one manager to enable rapid response to abnormal symptoms. At this time, the manager may be a medical staff member, guardian, device manager, etc., but is not limited thereto.

Hereinafter, embodiments of the present invention will be described in detail with reference to the attached drawings.

1 is a diagram showing the network structure of a neural monitoring system according to an embodiment of the present invention.

Referring to FIG. 1, the neural monitoring system 10 according to an embodiment of the present invention may include a neural monitoring device 100, an electrode module 200, and at least one manager terminal 300.

While the surgery is in progress, the nerve monitoring device 100 periodically or continuously monitors motor evoked potentials and somatosensory evoked potentials through at least one electrode attached to the patient's body to check for abnormalities in the patient. Depending on the confirmation results, set a monitoring cycle for each part. Thereafter, the neural monitoring device 100 periodically or continuously monitors the somatosensory evoked potential through at least one electrode attached to the patient's body after surgery to check whether there is an abnormality in the patient, and monitors based on the confirmation result. Information is generated and transmitted to at least one manager terminal 300. At this time, at least one manager terminal 300 that transmits monitoring information may be a pre-registered terminal.

During surgery, both motor evoked potentials and somatosensory evoked potentials from the patient are monitored to set the monitoring cycle to be applied after surgery. Since it is difficult to monitor motor evoked potentials from the patient after surgery, the set monitoring cycle is set after surgery. Based on this, only somatosensory evoked potentials are monitored.

The electrode module 200 may include at least one electrode unit attached to at least one part of the patient. At this time, the electrode module 200 may include a first electrode unit 201 attached to the motor nervous system and a second electrode unit 202 attached to the sensory nervous system.

Although FIG. 1 shows a first electrode unit 201 attached to the motor nervous system and a second electrode unit 202 attached to the sensory nervous system, this is for convenience of explanation and is attached to the motor nervous system and/or sensory nervous system. In order to monitor evoked potentials in various corresponding areas, a plurality of first electrode units and/or second electrode units may be provided.

Here, the electrode to which stimulation is applied may be a spiral cork-shaped electrode, needle electrode, or brain wave cup electrode. Anode stimulation is used on the scalp, and cathode stimulation is used for subcortical stimulation. Electrode positions for TES are expressed in the 10-10 electroencephalography system (10-10 system), which is a slightly modified version of the international 10-20 system for electroencephalography. When stimulation is applied using C3 and C4 (C3/C4), all motor evoked potentials of the arm and leg opposite the anode are recorded. C3/C4 stimulation has large movements and the stimulation is delivered to deep locations. Using C1/C2 is similar to C3/C4, but the degree of movement is weaker and the stimulation depth is shallower. Stimulating 1 cm behind and 6 cm in front of Cz (Cz-1/Cz+6) will stimulate both legs, and using the C3/Cz or C4/Cz position will mainly limit the movement evoked potential to the opposite face and arm. is formed.

Somatosensory evoked potentials can be recorded using surface electrodes or needle electrodes, and are performed by stimulating the median nerve in the upper extremity and the tibial nerve in the lower extremity. If monitoring of the lower neck, such as C8-T1, is required in the upper extremity, stimulate the ulnar nerve. If it is difficult to stimulate the tibial nerve in the lower extremities, the peroneal nerve or the tibial nerve in the popliteal fossa can be stimulated. Electrical stimulation provides a square-shaped stimulus through which a constant current of 0.2-0.3 ms flows, and the maximum stimulation intensity is about three times the stimulation threshold of the sensory nerve or twice the stimulation threshold of the motor nerve. In general, there are no side effects from repetitive stimulation, but repeated stimulation of the median nerve of the popliteus can cause anterior tibial compartment syndrome, so caution is required. To reduce 60Hz interference artifacts, the stimulation frequency avoids factoring 60Hz. Generally recommended stimulation frequencies include 4.7 and 5.1 Hz.

Meanwhile, at least one manager terminal 300 may be a terminal used by the manager, and displays monitoring information received from the neural monitoring device 100, allowing the manager to check the patient's condition.

Each mobile terminal, mobile phone, smart phone, laptop computer, desktop computer, digital broadcasting terminal, PDA (personal digital assistants), PMP (portable multimedia player), navigation, and slate PC ( slate PC, tablet PC, ultrabook, wearable device (e.g., smartwatch), glass-type terminal (smart glass), HMD (head mounted display), etc. It may be a computer device or a telecommunication device, but is not limited thereto.

Figure 2 is a diagram showing the configuration of a neural monitoring device according to an embodiment of the present invention.

Referring to Figure 2, the monitoring device 100 includes a communication module 110, a stimulus application module 120, a detection module 130, a processing module 140, a generation module 150, a storage module 160, and a control module. It is configured to include a module 170.

The communication module 110 transmits and receives at least one information or data to and from at least one manager terminal 300. In addition, this communication module 110 can perform communication with other servers or devices, and transmits and receives wireless signals in a communication network based on wireless Internet technologies.

Wireless Internet technologies include, for example, WLAN (Wireless LAN), Wi-Fi (Wireless-Fidelity), Wi-Fi (Wireless Fidelity) Direct, DLNA (Digital Living Network Alliance), WiBro (Wireless Broadband), and WiMAX (Worldwide). Interoperability for Microwave Access), HSDPA (High Speed Downlink Packet Access), HSUPA (High Speed Uplink Packet Access), LTE (Long Term Evolution), LTE-A (Long Term Evolution-Advanced), etc., and condition setting device (100 ) transmits and receives data according to at least one wireless Internet technology, including Internet technologies not listed above.

For short range communication, Bluetooth™, RFID (Radio Frequency Identification), Infrared Data Association (IrDA), UWB (Ultra Wideband), ZigBee, NFC (Near Field Communication), Wi -Short-distance communication can be supported using at least one of Fi (Wireless-Fidelity), Wi-Fi Direct, and Wireless USB (Wireless Universal Serial Bus) technologies. These wireless area networks can support wireless communication between the neural monitoring device 100 and at least one administrator terminal 300. At this time, the short-range wireless communication network may be a short-range wireless personal area network.

Meanwhile, the stimulation application module 120 applies a preset stimulation signal to each electrode attached to at least one part of the patient. Here, the stimulation signal can be applied by generating and transmitting an electrical current.

At this time, the stimulation application module 120 may apply different stimulation signals to the first stimulation unit 201 attached to the motor nervous system and the second stimulation unit 202 attached to the sensory nervous system.

However, this is only one embodiment, and may be configured to further generate other stimulation signals for monitoring other nervous systems other than the motor nervous system or sensory nervous system, but this is not limited.

The detection module 130 detects and amplifies the evoked potential generated by the stimulation signal applied to each electrode.

Specifically, the detection module 130 detects and amplifies the motor-evoked potential from the first stimulation unit 201, and detects and amplifies the somatosensory-evoked potential from the second stimulation unit 202.

The processing module 140 converts the amplified motor evoked potential and/or the amplified somatosensory evoked potential into digital signals and removes the noise signal to generate each monitoring signal.

Here, the monitoring signal is a combined variable used in the neural monitoring device 100 to know the nervous system state of the patient during or after surgery, including the occurrence time (Latency) of the peaks of the evoked potential and the amplitude of the peaks (Amplitude) ) is created using the value.

That is, the processing module 140 extracts the latency and amplitude of the peaks of the evoked potential that occur after the stimulus is applied from the evoked potential, and calculates the amplitude for the occurrence time of the peaks. The ratio is generated as a monitoring signal.

The generation module 150 compares each monitoring signal with a preset reference signal to check for abnormalities, and generates (sets) a monitoring cycle for each part based on the confirmation result.

Here, the patient's abnormality can be confirmed by comparing the waveform of each monitoring signal with the corresponding reference waveform (basic waveform). At this time, the reference waveform may be preset (stored) for each part.

The storage module 160 stores various data (information) received by the nerve monitoring device 100 or generated or acquired (measured) by the nerve sensing device 100, and contains at least one device required to monitor the patient's nerves. Save the process.

The control module 170 controls all components to perform an operation to monitor the patient's nerves based on at least one process stored in the storage module 160.

Specifically, the control module 170 applies a preset stimulation signal to each of the first electrode unit 201 attached to the motor nervous system and the second electrode unit 202 attached to the sensory nervous system of the patient undergoing surgery. After detecting and amplifying the motor-evoked potential and somatosensory-evoked potential generated from each of the first electrode unit 201 and the second electrode unit 202 by the stimulated signal, the amplified evoked potential is converted into a digital signal and made into noise. Each monitoring signal is generated by removing the signal, and each monitoring signal is compared with a preset reference signal to check for abnormalities, thereby controlling to set (save) the monitoring cycle for each part.

In addition, when the monitoring mode is set through an input signal from the administrator, the control module 170 applies a preset stimulation signal to the second electrode unit 202 based on the previously set monitoring cycle from the patient after surgery, and the applied After detecting and amplifying the somatosensory evoked potential generated from the second electrode unit 202 by the stimulation signal, the amplified somatosensory evoked potential is converted into a digital signal and the noise signal is removed to generate a monitoring signal. At this time, the control module 170 only tests somatosensory evoked potentials because it is impossible to test motor evoked potentials from patients after surgery.

Afterwards, the control module 170 checks whether there is an abnormality in the monitoring signal, and if there is an abnormality as a result of the confirmation, it generates monitoring information and transmits it to at least one pre-registered manager terminal 300.

In other words, the control module 170 attaches electrodes to the patient undergoing surgery to test the motor-evoked potential and somatosensory-evoked potential for each part, and determines the monitoring cycle to be applied after surgery based on the presence or absence of abnormalities according to the test results. After setting and saving each part, when it is set to monitoring mode, it is controlled to inspect the somatosensory evoked potential for each part based on the previously set monitoring cycle.

To this end, the neural monitoring device 100 may be configured to set an inspection mode or a monitoring mode, and each mode may be set according to an input signal from an administrator. When the test mode is set, the control module 170 checks the motor evoked potential and somatosensory evoked potential for each part through electrodes attached to at least one part of the patient to check for abnormalities, thereby determining the monitoring cycle to be applied in the monitoring mode. is set for each part, and when the monitoring mode is set, the somatosensory evoked potential for each part is checked through electrodes attached to at least one part of the patient to check for abnormalities, and at least one pre-registered through monitoring information It may be determined whether to notify the administrator terminal 300.

Meanwhile, although not shown in FIG. 2, the neural monitoring device 100 may further include an input module, an imaging module, and a display module. Through this display module, not only surveillance signals but also videos or images acquired through the imaging module can be displayed so that the manager can visually check the data, and information (data) or various signals can be input through the input module.

Additionally, the neural monitoring device 100 may be configured to include more or fewer components in addition to the components shown in FIG. 2.

Figure 3 is a flowchart showing a control method for performing a neural monitoring device according to an embodiment of the present invention.

The neural monitoring device 100 applies a preset stimulation signal to each of the first electrode unit 201 attached to the motor nervous system and the second electrode unit 202 attached to the sensory nervous system of the patient undergoing surgery (S301). The motor-evoked potential and the somatosensory-evoked potential generated from each of the first electrode unit 201 and the second electrode unit 202 by the applied stimulation signal are detected and amplified (S303).

Afterwards, the neural monitoring device 100 converts the two evoked potentials amplified in step S303 into digital signals and removes the noise signal to generate each monitoring signal (S305), and then converts each monitoring signal into a preset reference signal and By comparing, any abnormalities are checked and a monitoring cycle to be applied after surgery is set (S307).

Here, the monitoring cycle can be set as shown in <Table 1> below.

motor evoked potential Somatosensory evoked potentials monitoring cycle Is it abnormal? ○ ○ T1 ○ × T2 × ○ T3 × × T4

In other words, the monitoring period is divided into cases where there is an abnormality in both motor evoked potentials and somatosensory evoked potentials, cases where there is an abnormality in motor evoked potentials or somatosensory evoked potentials, and cases where there are no abnormalities in both motor evoked potentials and somatosensory evoked potentials. It can be set differently for each part. Since this monitoring cycle requires more intensive management of abnormal areas, it can be set in the order of T1<T2≤T3<T4 or T1<T3≤T2<T4. In other words, when an abnormality is confirmed, the monitoring cycle is set shorter to monitor more intensively.

Next, when the monitoring mode is set through the administrator's input signal, the neural monitoring device 100 sends a preset stimulation signal to the second electrode unit 202 from the postoperative patient based on the monitoring cycle set in step S307. It is applied (S309), and the somatosensory evoked potential generated from the second electrode unit 202 by the applied stimulus signal is detected and amplified (S311).

Afterwards, the neural monitoring device 100 converts the somatosensory evoked potential amplified in step S311 into a digital signal and removes the noise signal to generate a monitoring signal (S313), and the waveform and reference waveform (basic waveform) of the generated monitoring signal. Check for abnormalities in the patient by comparing waveforms (315).

Thereafter, if it is determined in step S315 that there is an abnormality in the patient, the neural monitoring device 100 generates monitoring information based on the monitoring signal generated in step S313 and transmits it to at least one pre-registered manager terminal 300. Do it (S317). At this time, step 317 is performed only when it is determined that there is an abnormality in the patient, and can be omitted when it is determined that there is no abnormality. At this time, step 317 is performed only when it is determined that there is an abnormality in the patient, and can be omitted when it is determined that there is no abnormality.

Here, the surveillance information may include at least one of the patient's personal information, information on abnormal symptoms, and surveillance signal information, and may be visualized and displayed through the display unit of at least one pre-registered administrator terminal 300. In addition, patient groups (e.g., very high risk group, high risk group, etc.) can be classified according to the degree of abnormality of the patient in the surveillance information.

Meanwhile, when change information for changing the set period is received from at least one manager terminal 300, the neural monitoring device 100 may change the set period based on the change information. For example, if the manager determines through monitoring information that there is a serious abnormal reaction in somatosensory evoked potentials measured in a specific area, the monitoring cycle is changed to a shorter period than the previously set period for more intensive monitoring of that specific area. It can be done.

Additionally, when a specific manager inputs and records opinions or actions regarding the monitoring information, the recorded opinions or actions may be shared with other managers.

Figure 4 is a diagram showing an example of test information displayed through a display unit of a neural monitoring device according to an embodiment of the present invention.

The neural monitoring device 100 may be configured to include a display unit, or may be provided by connecting a separate display device, and the test information or surveillance information generated through the neural monitoring device 100 through this display unit (display device). may be displayed.

Specifically, as the neural monitoring device 100 operates in a test mode during surgery, the test results, that is, monitoring signals for each motor evoked potential and somatosensory evoked potential and their measured values, can be displayed as test information. In addition, images (videos) of the surgical site as well as various data (blood pressure, heart rate, respiration, oxygen saturation, etc.) related to the patient's current condition can be displayed together on the display unit 180.

Figures 5A to 5C are diagrams showing an example of monitoring information displayed through a display unit of an administrator terminal in a neural monitoring system according to an embodiment of the present invention.

Referring to FIG. 5A, the manager terminal 300 visualizes and displays the monitoring information received from the neural monitoring device 100 on the display unit 310.

Specifically, the patient's personal information and surgical information are displayed, and the manager can check for abnormal reactions through the waveform of the surveillance signal where abnormalities are detected.

In addition, referring to FIG. 5b, the manager terminal 300 allows the manager who has confirmed the monitoring information to check the monitoring cycle of the patient and enter and record his or her opinions on adverse reactions as well as the corresponding measures. Configure the user interface so that

Meanwhile, referring to FIG. 5C, the manager terminal 300 can provide monitoring information by including data related to evoked potentials for multiple patients in the form of a list, through which the manager can monitor evoked potentials during surgery for multiple patients. It is possible to check the cause of the abnormality as well as the postoperative progress according to the measures (management).

However, in Figure 5c, the list is shown as including only data on motor evoked potentials, but this is only one embodiment and may be configured to include not only data on somatosensory evoked potentials but also other data. It may be possible.

5A to 5C may be displayed on one screen and may be configured to be partially viewed by scrolling.

The steps of the method or algorithm described in connection with embodiments of the present invention may be implemented directly in hardware, implemented as a software module executed by hardware, or a combination thereof. The software module may be RAM (Random Access Memory), ROM (Read Only Memory), EPROM (Erasable Programmable ROM), EEPROM (Electrically Erasable Programmable ROM), Flash Memory, hard disk, removable disk, CD-ROM, or It may reside on any type of computer-readable recording medium well known in the art to which the present invention pertains.

Above, embodiments of the present invention have been described with reference to the attached drawings, but those skilled in the art will understand that the present invention can be implemented in other specific forms without changing its technical idea or essential features. You will be able to understand it. Therefore, the embodiments described above should be understood in all respects as illustrative and not restrictive.

100: Neural monitoring device 200: Electrode module
201: first electrode portion 202: second electrode portion
300: At least one manager terminal 110: Communication module
120: Stimulus application module 130: Detection module
140: processing module 150: generation module
160: storage module 170: control module

Claims (10)

a stimulation application module that applies a preset stimulation signal to an electrode attached to at least one body part of the patient;
a processing module that generates a monitoring signal for the evoked potential generated and detected by the stimulation signal;
a generation module that compares the generated monitoring signal with a preset reference signal to check whether there is an abnormality in the patient, and generates a monitoring cycle for each of the at least one body part based on the confirmation result;
It includes a control module that performs operations to monitor the patient's nerves,
The control module is,
When the patient is undergoing surgery, control the processing module to generate monitoring signals for motor evoked potentials and somatosensory evoked potentials,
When the patient is after surgery, a specific stimulation signal is applied to the electrode attached to the sensory nervous system among the electrodes based on the generated monitoring cycle, and a monitoring signal for the somatosensory evoked potential generated and detected by the specific stimulation signal is applied. Control the processing module to generate,
The generation module is characterized in that it sets the monitoring cycle for each body part depending on which of the motor evoked potentials and somatosensory evoked potentials is abnormal for each body part,
Neural monitoring device.
delete According to paragraph 1,
Comprising a first electrode attached to the patient's motor nervous system and a second electrode attached to the sensory nervous system,
Neural monitoring device.
According to paragraph 1,
a detection module that detects and amplifies the evoked potential;
The processing module is,
Characterized in that the evoked potential amplified by the detection module is converted into a digital signal and the noise signal is removed to generate the monitoring signal.
Neural monitoring device.
According to paragraph 1,
Characterized in that the monitoring signal is a combined variable used to determine the nervous system state of the patient during or after surgery,
Neural monitoring device.
According to clause 5,
The processing module extracts the occurrence times of peaks of the evoked potential and the amplitudes of the peaks from the evoked potential,
Characterized in generating the monitoring signal based on the ratio of the amplitude to the occurrence time of the peaks,
Neural monitoring device.
According to paragraph 1,
The control module determines whether there is an abnormality in the patient by comparing the waveform of the generated monitoring signal with the corresponding reference waveform,
The neural monitoring device further includes a storage module in which the reference waveform preset for each region is stored,
Neural monitoring device.
According to paragraph 1,
The control module is,
When an abnormal reaction exists in the evoked potential measured in a specific body part of the patient, the monitoring cycle generated for the specific body part is controlled to be changed to a shorter cycle,
Neural monitoring device.
A method performed by a neural monitoring device, comprising:
Applying a preset stimulation signal to an electrode attached to at least one body part of the patient;
generating a monitoring signal for an evoked potential generated and detected by the stimulus signal; and
Comparing the generated monitoring signal with a preset reference signal to check whether there is an abnormality in the patient, and generating a monitoring cycle for each of the at least one body part based on the confirmation result,
The neural monitoring device,
When the patient is undergoing surgery, control the processing module to generate monitoring signals for motor evoked potentials and somatosensory evoked potentials,
When the patient is after surgery, a specific stimulation signal is applied to the electrode attached to the sensory nervous system among the electrodes based on the generated monitoring cycle, and a monitoring signal for the somatosensory evoked potential generated and detected by the specific stimulation signal is applied. Control the processing module to generate,
Characterized in that the monitoring cycle is set for each body part depending on which of the motor evoked potentials and somatosensory evoked potentials is abnormal for each body part,
Neuromonitoring methods.
A program combined with a hardware computer and stored in a medium to execute the method of claim 9.

Images