摘要或動機

Pedicle probes are medical devices used by surgeons during spinal fusions for patients with conditions such as scoliosis and spinal fractures. The probe creates pilot holes to guide the placement of pedicle screws in vertebrae. The screws are then connected with a metal rod to stabilize the spine. Twenty-nine percent of patients who undergo spinal fusions suffer from vertebral breaches – accidental damage to the spinal cord – which cause complications such as infection, motor defects, and in many cases paralysis. My goal was to make spinal fusions safer by redesigning the pedicle probe to provide surgeons with instantaneous feedback on the probe’s location, enabling them to more accurately place pedicle screws. The pedicle probe I developed takes advantage of the difference in density between the inner cancellous (spongy) bone and the outer cortical (compact) bone found in vertebrae. Cortical bone is avoided by monitoring the cannulation force – the force required to insert the probe. When the probe contacts denser cortical tissue, it warns the user by providing tactile and visual feedback through a vibration motor and an LED. This enables the surgeon to redirect the probe and advance down the optimum path, preventing a possible breach. It proved successful in preventing breaches on lamb vertebrae, which closely resemble human vertebrae. This novel device improves feedback to the surgeon and eliminates the need for costly and potentially harmful ionizing radiation exposure. Furthermore, it does not depend on, or require, any preoperative imaging. The cost of manufacturing the improved probe is less than $42 USD (NT$1297). Results of patent searches for 加拿大, the 美國, and Europe suggest that the redesigned probe is unique in predicting and preventing breaches in spinal fusions based on predetermined force threshold values. The probe is also unique in enabling personalized procedures in spinal fusions for those with complications, through calibrating a control (force) limit based on tissue samples prior to the procedure. Enhancing a surgeon’s ability to determine an appropriate path for pedicle screws through a sensor-enabled probe has the potential to significantly reduce the incidence of vertebral breaches during spinal fusion surgery.