University of Pittsburgh researchers have developed a novel approach to detect skull fractures and skull slippage associated with the use of a Mayfield or similar skull clamp during neurosurgical procedures. Using a transducer coupled directly to a pin on the skull clamp, it will be possible for surgical teams to directly monitor skull bone stability and clamping effectiveness during a procedure by analysis of acoustic emissions (AE). This novel approach could detect skull stress and impending slippage early and warn teams of potential damage allowing for clamp repositioning, ultimately improving outcomes. The transducer could also be affixed to non-cranial bone implants and orthosis for a similar intent and has been separately validated in long bones.
Attachment of an acoustic sensor to one or more pins on a Mayfield skull clamp can be used to detect risk of skull fracture during neurosurgical procedures. Mayfield skull clamp, indicating 1) single pin mount, 2) double pin mount, 3) screw drive, 4) ratchet mechanism.
Description
Skull clamps are used to stabilize the head during surgical procedures. Under- or over- tightening of pins when securing the clamp can result in various injuries. This device is designed to detect AE from bones and could warn surgeons if the clamp pressure is too high and likely to cause injury, or too low and likely to slip, leading to the development of more secure clamping protocols. Overall, this novel application has the potential to prevent surgical injuries and save patient lives.
Applications
- Neurosurgery
- Orthopedics
- Craniofacial
- ENT
- Surgical injury prevention
Advantages
While skull clamps are vital in neurosurgery, when incorrectly applied, they can slip causing deep lacerations. Similarly, too much force being applied can lead to serious skull fractures. This damage can destabilize the head during surgery and can lead to catastrophic complications including laceration of intracranial vessels and the dura mater, resulting in life threatening intracranial hemorrhage.
The occurrence of AE from bone fractures is well established and this novel device harnesses AE to detect bone weakness like techniques used in geological monitoring where changes in the frequency of AE can be indicative of changes in the stability of structures. In this novel device, an AE detection transducer can be coupled to a skull pin in a skull clamp. Through monitoring and analysis of AE, micro-cracking in bone can be detected and feedback provided in real-time to clinical teams, acting as a warning system to prevent serious damage to the skull bone or slippage.
Invention Readiness
A prototype has been developed with an AE detection transducer coupled to one skull pin. Testing was carried out on a cadaver skull and included sections which had been manually weakened at points. Loading of the skull clamp was varied up to 120 lbs to determine the AE of stability, instantaneous failure and time-delayed failure. All were found to produce uniquely interpretable AE signals. Slippage of pins was also simulated in this setting and separate stereotypical AEs were detected. Further work will be required to optimize this system including development of customized AE detection transducers suitable for detection of microcracking in bones.
IP Status
Patent Pending
