Estimation of Penetrated Bone Layers During Craniotomy via Bioimpedance Measurement

Abstract

Based on the results of this study, bioimpedance measurement seems to be a promising option for intra operative ad hoc information about the bone layer currently penetrated and could contribute to patient safety during neurosurgery.

Smart bioimpedance-controlled craniotomy: Concept and first experiments

“…Although the curve characteristics also seem to correspond with the static measurements, Figure 6. Bioimpedance characteristics identified for bone sawing: (a) static impedance measurement results, (b) FEM simulation of impedance measurement, 15 and (c) dynamic impedance measurement during sawing process.…”

“…Whereas this approach has been investigated for bone milling and drilling 9–11 as well as for bone cement milling, 12,13 the control of a sawing process has not yet been realized and evaluated. Our initial finite element method (FEM) simulations reported by Teichmann and colleagues 14,15 show promising results so far. Based on these findings, this article focuses on the integration of the bioimpedance sensors into the bone saw device and its experimental evaluation.…”

“…The experimental evaluation is done for the bipolar measurement principle as the results of our initial FEM simulations suggest that this principle is superior to the monopolar measurement. 15 However, it may be advantageous to combine both principles in a hybrid concept, which will be part of our future work. Figure 4 depicts the experimental setup.…”

Fundamentals, Recent Advances, and Future Challenges in Bioimpedance Devices for Healthcare Applications

“…The polarity of the electrodes has also been analyzed in an application that uses bioimpedance as a guidance method during the craniotomy [101]. According to these results, a bipolar scheme, in which two opposite currents are injected into the medium at the same time in two different positions, is more sensitive than a monopolar scheme, with a single injection point.…”

“…Although bioimpedance measurement technology is a mature method, a major research effort must be made in conjunction with experts in clinical diagnosis to improve the sensitivity, the specificity, and the confidence in the use of technology in routine clinical practice. Another challenge faced by bioimpedance is the research and development of new applications, in which the detection of cancer will have a prominent position [31,37,65,68], but other new applications are feasible such as lymphoedema evaluation [43,48], vital sign monitoring in automotive environments [377], noninvasive cuffless blood pressure estimation [378][379][380][381], electrical impedance myography [382], glucose concentration assessment [383,384], noninvasive detection of physiological processes [385], diagnosis of diseases of peripheral vascular system [43,386], evaluation of elbow joint motion [387], detection of bacteria populations in water solutions [388], evaluation of the status of wound healing [389], infiltration detection during intravenous therapy [390], blood flow assessment [43], and characterization of an implantable neurostimulator [391], as a surgical aid tool [101,392] or in the evaluation of transplanted organs [46].…”