Bionic Reconstruction After Severe Neural Loss
摘要
Upper extremity amputation presents a major therapeutic challenge as patients may experience chronic pain and severe limitations in their daily lives. Conventional myoelectric prostheses are limited in their ability to replace important limb functions, as they are restricted to two control signals of remaining agonist and antagonist stump muscles. Bionic reconstruction uses targeted muscle reinnervation (TMR) to selectively transfer amputated extremity nerves to motor branches of remaining muscles, generating up to six distinct myosignals. After rehabilitation and cortical reprogramming, electromyography (EMG) signals are used for prosthetic control (Kuiken TA et al., Prosthet Orthot Int 28:245–253, 2004). This allows patients to intuitively and simultaneously control joints in multi-degree-of-freedom myoelectric prostheses (Farina D, Aszmann O, Sci Transl Med 6:257ps12, 2014). This approach is most suitable for above-elbow amputees, as surgeons can anchor the prosthesis to the bone via osseointegration, thus providing mechanical coupling and superior fixation (Ortiz-Catalan M et al., N Engl J Med 382:1732–1738, 2020).