Intraoperative Demonstration of Selective Stimulation of the Common Human Femoral Nerve with a FINE

• Published in: 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society Vol. 2009; pp. 610 - 613
• Main Authors: Schiefer, M.A., Polasek, K.H., Triolo, R.J., Pinault, G.C., Tyler, D.J.
• Format: Conference Proceeding Journal Article
• Language: English
• Published: United States IEEE 01.01.2009
• Subjects: Electric Stimulation - instrumentation; Electric Stimulation - methods; Electrodes; Electrodes, Implanted; Electromyography; Equipment Design; Equipment Failure Analysis; Femoral Nerve - physiology; Hip; Humans; Intraoperative Care; Knee; Ligaments; Muscle Contraction - physiology; Muscle, Skeletal - innervation; Muscle, Skeletal - physiology; Muscles; Recruitment; Reproducibility of Results; Sensitivity and Specificity; Surges; Testing
• ISSN: 1094-687X; 1557-170X; 1558-4615
• DOI: 10.1109/IEMBS.2009.5332757

We have tested the hypothesis that the Flat Interface Nerve Electrode (FINE) can selectively stimulate each muscle innervated by the common femoral nerve of the human, near the inguinal ligament in a series of intraoperative trials. During routine vascular surgeries, an 8-contact FINE was placed around the common femoral nerve between the inguinal ligament and the first branching point. The efficacy of the FINE to selectively recruit muscles innervated by the femoral nerve was determined from electromyograms (EMGs) recorded in response to electrical stimulation. At least four of the six muscles innervated by the femoral nerve were selectively recruited in all subjects. Of these, at least one muscle was a hip flexor and two muscles were knee extensors. Results from the intraoperative experiments were used to estimate the potential for the electrode to restore knee extension and hip flexion through Functional Electrical Stimulation (FES). Normalized EMGs and biomechanical simulations were used to estimate joint moments and functional efficacy. Estimated knee extension moments exceed the threshold required for the sit-to-stand transition.