Smith B T, Betz R R, Mulcahey M J, Triolo R J
Research Department, Shriners Hospitals for Crippled Children, Philadelphia, PA 19152.
Arch Phys Med Rehabil. 1994 Sep;75(9):939-45.
Chronically indwelling percutaneous intramuscular electrodes were implanted in the upper extremity muscles of five adolescents with C5 or C5-6 tetraplegia in an effort to provide lateral and palmar prehension using the neuroprosthetic system designed by Case Western Reserve University. The responses from 177 electrodes were evaluated at 3-month intervals and included measurements of electrical impedance and an assessment of recruitment properties. Electrode failures were categorized as breakage, an altered stimulated response or adverse sensation during stimulation. Survival probabilities were generated for all electrodes, each muscle group, the volar and dorsal exit sites, intrinsic and extrinsic muscles, and according to the subjects' time postinjury. The overall probability of an electrode surviving to 6 months was 0.75 and the 1 year survival probability was 0.56. Among muscle groups, the finger extensor and thumb adductor electrodes had the highest proportion of failures and the poorest survival likelihoods within the first year after implant. According to the Breslow test, significantly smaller survival chances were predicted for electrodes exiting dorsally and for the newly-injured adolescents (< 1 year postinjury). The cumulative survival likelihoods of this study are smaller than those reported in adult applications using the same electrode design. Factors that may account for the disparate results are discussed.
将慢性植入式经皮肌内电极植入五名患有C5或C5-6四肢瘫痪的青少年的上肢肌肉中，旨在使用凯斯西储大学设计的神经假体系统实现外侧和掌侧抓握功能。每隔3个月对177个电极的反应进行评估，包括电阻抗测量和募集特性评估。电极故障分为断裂、刺激反应改变或刺激期间出现不良反应。计算了所有电极、每个肌肉群、掌侧和背侧引出部位、固有肌和外在肌的存活概率，并根据受试者受伤后的时间进行了计算。电极存活至6个月的总体概率为0.75，1年存活概率为0.56。在肌肉群中，手指伸肌和拇内收肌电极的故障比例最高，植入后第一年的存活可能性最差。根据Breslow检验，预测背侧引出的电极以及新受伤的青少年（受伤后<1年）的存活机会明显较小。本研究的累积存活可能性低于使用相同电极设计的成人应用报告中的存活可能性。讨论了可能导致不同结果的因素。
