术中实时远程神经生理监测(IONM)的发展

Jeffrey Balzer, Julia Caviness, Don Krieger
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摘要

实时监测神经系统功能,并将相关信息及时传达给外科医生,可以在许多外科手术中预防和/或减轻肌萎缩性损伤。支持ionmori的远程医疗的硬件和软件基础设施以及已证明的有用性起源于繁忙的大学医疗中心环境,然后随着商业设备制造商添加的类似功能而广泛传播。最早的实现包括原始的数据存档和案例文档功能,并且主要依赖于安全性的识别。他们强调远程观察者对实时数据显示的全功能控制。如今,在美国,每年有超过20万例高风险手术常规使用远程IONM。在许多情况下,远程观察者依靠屏幕捕获来查看远程手术室中显示的数据,同时提供复杂的安全功能和数据存档以及标准化的元数据和案例文档。
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The Evolution of Real-time Remote Intraoperative Neurophysiological Monitoring (IONM)
Real-time monitoring of nervous system function with immediate communication of relevant information to the surgeon enables prevention and/or mitigation of iatrogenic injury in many surgical procedures. The hardware and software infrastructure and demonstrated usefulness of telemedicine in support of IONM originated in a busy university health center environment and then spread widely as comparable functional capabilities were added by commercial equipment manufacturers. The earliest implementations included primitive data archival and case documentation capabilities and relied primarily on deidentification for security. They emphasized full-featured control of the real-time data display by remote observers. Today, remote IONM is routinely utilized in more than 200,000 high-risk surgical procedures/year in the United States. For many cases, remote observers rely on screen capture to view the data as it is displayed in the remote operating room while providing sophisticated security capabilities and data archival and standardized metadata and case documentation.
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