Alternate Control Technology Methodologies for Cybernetic Prosthesis: Difference between revisions
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<h3>Introduction</h3> | <br><h3>Abstract</h3> | ||
After atypical nervous system damage suffered while on duty as a Starfleet security officer, a 26-year-old (Earth Standard) female metagenetic Klingon suffered a loss of prosthetic control concurrent with severe physical discomfort. Due to the extensive nature of the nervous system damage, standard prosthetic control methodologies were discovered to be non-viable. Working in tandem with the primary attending physician, the Engineering team of the USS Veritas (Starfleet Registry NCC-95035) designed, tested and implanted a novel transceiver module which provides positive prosthetic control without further stress on the patient’s nervous system. This module, after proper peer review, will allow for a radical new archetype in prosthetic design and implementation in humanoid subjects. | |||
<br><h3>Introduction</h3> | |||
At present, when attending to cases of extremity loss, Federation physicians have limited options available to them when it comes to limb replacement and subsequent physical therapy. While bio-grafting and ninth-generation cybernetic limbs are versatile and proven therapeutic approaches, they do have limitations and fundamentally rely on the patient’s existing nervous system for functionality. While this is typically viewed favorably as it keeps rejection rates extremely low, there are some cases where typical neuro-servo control apparatuses are non-suitable. While this group has historically been statistically small, it is still a significant underserved patient base. | At present, when attending to cases of extremity loss, Federation physicians have limited options available to them when it comes to limb replacement and subsequent physical therapy. While bio-grafting and ninth-generation cybernetic limbs are versatile and proven therapeutic approaches, they do have limitations and fundamentally rely on the patient’s existing nervous system for functionality. While this is typically viewed favorably as it keeps rejection rates extremely low, there are some cases where typical neuro-servo control apparatuses are non-suitable. While this group has historically been statistically small, it is still a significant underserved patient base. | ||
<br>Prior experimentation with alternate control apparatuses have been hampered by the size of existing components and their suitability for safe installation. This kept most alternates from moving beyond the prototype or early trial stage, and had remained an unresolved challenge for a subset of patients. | <br>Prior experimentation with alternate control apparatuses have been hampered by the size of existing components and their suitability for safe installation. This kept most alternates from moving beyond the prototype or early trial stage, and had remained an unresolved challenge for a subset of patients. | ||
<br><h3>Case Presentation</h3> | <br><h3>Case Presentation</h3> | ||
A 26-year-old (Earth Standard) metagenetic Klingon female Starfleet security officer, was critically injured in the line of duty on Stardate 239601.12 when her right arm was severed by an indigenous predator on the previously uncharted world Limbo.<ref>[https://wiki.starbase118.net/wiki/index.php?title=Limbo_(Veritas) "Limbo (Veritas)"] Starbase 118, Stardate 239601.12</ref> Field conditions did not allow for the standard therapeutic treatments of bio-grafting, and the subject was forced to remain in an injured state for several months with only minimal medical resources available to control shock, blood loss, and infection. Subsequent infections resulted in the complete amputation of the arm. | A 26-year-old (Earth Standard) metagenetic Klingon female Starfleet security officer, was critically injured in the line of duty on Stardate 239601.12 when her right arm was severed by an indigenous predator on the previously uncharted world Limbo.<ref>[https://wiki.starbase118.net/wiki/index.php?title=Limbo_(Veritas) "Limbo (Veritas)"] Starbase 118, Stardate 239601.12</ref> Field conditions did not allow for the standard therapeutic treatments of bio-grafting, and the subject was forced to remain in an injured state for several months with only minimal medical resources available to control shock, blood loss, and infection. Subsequent infections resulted in the complete amputation of the arm.[[File:Cyberarm.JPG|right|thumb|225px|Patient's original prosthetic.]] | ||
<br>When the patient was successfully evacuated to a specialized medical facility, extensive surgical intervention was required to successfully remove subsequent necrotic tissue from the original injury site prior to the installation of a type eleven scapula supplement mount, connected across the remaining bone tissue with microsutures and several hundred tritanium self-sealing micro-anchors. The brachial plexus was found to be in acceptable condition to support a standard neuro-servo control interface, although the axial and ulnar nerve sheaths had been damaged. The interface was surgically implanted and tested successfully by the attending surgeon at the time. During subsequent physical reconditioning, the patient expressed frustration and discomfort, which required additional therapeutic focus to overcome. After several weeks, she was discharged and returned to duty with instructions to work closely with her shipboard medical staff for any further issues. | <br>When the patient was successfully evacuated to a specialized medical facility, extensive surgical intervention was required to successfully remove subsequent necrotic tissue from the original injury site prior to the installation of a type eleven scapula supplement mount, connected across the remaining bone tissue with microsutures and several hundred tritanium self-sealing micro-anchors. The brachial plexus was found to be in acceptable condition to support a standard neuro-servo control interface, although the axial and ulnar nerve sheaths had been damaged. The interface was surgically implanted and tested successfully by the attending surgeon at the time. During subsequent physical reconditioning, the patient expressed frustration and discomfort, which required additional therapeutic focus to overcome. After several weeks, she was discharged and returned to duty with instructions to work closely with her shipboard medical staff for any further issues. | ||
<br>In the course of her duties, the patient’s prosthetic was directly exposed to multiple exotic high energy discharges, which radiated from the prosthetic through the patient’s entire central nervous system, initially presenting symptoms of mild electrocution. Medical staff were engaged subsequent to this exposure and, aside from minor symptoms that were attributed to the incident itself, the patient was discharged with a clean bill of health and continued to perform her duties without interruption for several additional days. | [[File:Nerves_of_the_Arm.gif|left|thumb|125px|Nerves in the typical humanoid arm.<ref>Gray, Henry. ''Anatomy of the Human Body.'' (1918).</ref>]]<br>In the course of her duties, the patient’s prosthetic was directly exposed to multiple exotic high energy discharges, which radiated from the prosthetic through the patient’s entire central nervous system, initially presenting symptoms of mild electrocution. Medical staff were engaged subsequent to this exposure and, aside from minor symptoms that were attributed to the incident itself, the patient was discharged with a clean bill of health and continued to perform her duties without interruption for several additional days. | ||
<br> | <br>Later, however, the patient awoke in significant physical discomfort and found that the prosthetic was no longer functioning in an acceptable manner. In the course of seeking medical attention, the prosthetic malfunctioned significantly, causing the patient severe radiating pain and a total loss of limbic motor control. Comprehensive medical examination revealed the prosthetic itself had been severely damaged by the high energy discharges, and this damage had spread to the neuro-servo control interface and the brachial plexus nerves themselves, causing significant peripheral neuropathy. Coupled with the existing damage to the nerve tissues, this prevented the patient from generating adequate nervous system feedback to activate and control a standard neuro-servo interface, even after the damaged unit was removed and replaced. Her prognosis for recovery and return to duty at this point was non-favorable. | ||
<br>[[File: | <br>[[File:Targeted Muscle Reinnervation.jpg|right|thumb|150px|Former techniques that the current methods are based on.<ref>[https://www.scribd.com/document/92161222/History-of-the-Myoelectric-Arm-Redo "History of the Myoelectric Arm"] Ladha, Sanchit. ''History of the Myoelectric Arm''. </ref>]] | ||
<br>Several Starfleet engineers serving with the patient became aware of her condition and began examining the data provided by attending medical staff regarding the component malfunctions. Working in tandem with medical staff, the engineers began a comprehensive disassembly of the patient’s prosthetic, with which they already had some familiarity due to improvised repairs and upgrades conducted at an earlier juncture. They discovered that numerous control components of the original prosthetic were severely damaged and began laboring to extract them in an attempt to save the existing unit. In the course of their repairs, the nature and extent of the damage to the patient’s nervous system became clear, which led the team to the conclusion that standard surgical approaches were insufficient. In an effort to provide an immediate, workable solution, the Engineering team approached the patient’s injuries in the same manner in which they’d approach shipboard damage control efforts - they attempted to bypass the damaged systems and reroute the nervous system control impulses. After performing a series of simulations to verify their hypothesis, the Engineering team began modifying a pair of subspace transceivers to serve as a replacement for the standard neuro-servo control interface that would not rely on the damaged brachial nerves. Subsequent assembly and testing was conducted rapidly and, post repairs, the patient was again able to manipulate her prosthetic effectively and without accidental input or injury.<ref>[https://wiki.starbase118.net/wiki/index.php?title=SIM:JP:_Lt._Teller,_Lt._G%27var,_Lt._JG_Ukinix,_Lt._JG_MacKenzie,_and_Ens._Vanlith:_Helping_Hands "SIM:JP: Lt. Teller, Lt. G'var, Lt. JG Ukinix, Lt. JG MacKenzie, and Ens. Vanlith: Helping Hands"] Starbase 118, Stardate 239606.20</ref> | |||
<br><h3>Discussion</h3> | <br><h3>Discussion</h3>[[File:Vladislav-ociacia-hands-arm-wrestling-2.jpg|right|thumb|225px|Patient's new prosthetic.]] | ||
The patient has since taken a leave of absence from active duty but after significant nervous system rehabilitation, follow-up consultations with her medical team point to a full integration with this new interface design with a significant improvement in neural feedback levels over the existing standard. | The patient has since taken a leave of absence from active duty but after significant nervous system rehabilitation, follow-up consultations with her medical team point to a full integration with this new interface design with a significant improvement in neural feedback levels over the existing standard. | ||
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<br><h3>References</h3> | <br><h3>References</h3> | ||
[[Category:Journal of Starfleet Medicine]] | [[Category:Journal of Starfleet Medicine]] |
Latest revision as of 23:15, 26 August 2019
2396, Vol. 323, No. 3
Alternate Control Technology Methodologies for Cybernetic Prosthesis
Addison MacKenzie, M.D., Ph.D., FASFS & Geoffrey Teller, Starfleet Corps of Engineers
Abstract
After atypical nervous system damage suffered while on duty as a Starfleet security officer, a 26-year-old (Earth Standard) female metagenetic Klingon suffered a loss of prosthetic control concurrent with severe physical discomfort. Due to the extensive nature of the nervous system damage, standard prosthetic control methodologies were discovered to be non-viable. Working in tandem with the primary attending physician, the Engineering team of the USS Veritas (Starfleet Registry NCC-95035) designed, tested and implanted a novel transceiver module which provides positive prosthetic control without further stress on the patient’s nervous system. This module, after proper peer review, will allow for a radical new archetype in prosthetic design and implementation in humanoid subjects.
Introduction
At present, when attending to cases of extremity loss, Federation physicians have limited options available to them when it comes to limb replacement and subsequent physical therapy. While bio-grafting and ninth-generation cybernetic limbs are versatile and proven therapeutic approaches, they do have limitations and fundamentally rely on the patient’s existing nervous system for functionality. While this is typically viewed favorably as it keeps rejection rates extremely low, there are some cases where typical neuro-servo control apparatuses are non-suitable. While this group has historically been statistically small, it is still a significant underserved patient base.
Prior experimentation with alternate control apparatuses have been hampered by the size of existing components and their suitability for safe installation. This kept most alternates from moving beyond the prototype or early trial stage, and had remained an unresolved challenge for a subset of patients.
Case Presentation
A 26-year-old (Earth Standard) metagenetic Klingon female Starfleet security officer, was critically injured in the line of duty on Stardate 239601.12 when her right arm was severed by an indigenous predator on the previously uncharted world Limbo.[1] Field conditions did not allow for the standard therapeutic treatments of bio-grafting, and the subject was forced to remain in an injured state for several months with only minimal medical resources available to control shock, blood loss, and infection. Subsequent infections resulted in the complete amputation of the arm.
When the patient was successfully evacuated to a specialized medical facility, extensive surgical intervention was required to successfully remove subsequent necrotic tissue from the original injury site prior to the installation of a type eleven scapula supplement mount, connected across the remaining bone tissue with microsutures and several hundred tritanium self-sealing micro-anchors. The brachial plexus was found to be in acceptable condition to support a standard neuro-servo control interface, although the axial and ulnar nerve sheaths had been damaged. The interface was surgically implanted and tested successfully by the attending surgeon at the time. During subsequent physical reconditioning, the patient expressed frustration and discomfort, which required additional therapeutic focus to overcome. After several weeks, she was discharged and returned to duty with instructions to work closely with her shipboard medical staff for any further issues.
In the course of her duties, the patient’s prosthetic was directly exposed to multiple exotic high energy discharges, which radiated from the prosthetic through the patient’s entire central nervous system, initially presenting symptoms of mild electrocution. Medical staff were engaged subsequent to this exposure and, aside from minor symptoms that were attributed to the incident itself, the patient was discharged with a clean bill of health and continued to perform her duties without interruption for several additional days.
Later, however, the patient awoke in significant physical discomfort and found that the prosthetic was no longer functioning in an acceptable manner. In the course of seeking medical attention, the prosthetic malfunctioned significantly, causing the patient severe radiating pain and a total loss of limbic motor control. Comprehensive medical examination revealed the prosthetic itself had been severely damaged by the high energy discharges, and this damage had spread to the neuro-servo control interface and the brachial plexus nerves themselves, causing significant peripheral neuropathy. Coupled with the existing damage to the nerve tissues, this prevented the patient from generating adequate nervous system feedback to activate and control a standard neuro-servo interface, even after the damaged unit was removed and replaced. Her prognosis for recovery and return to duty at this point was non-favorable.
Several Starfleet engineers serving with the patient became aware of her condition and began examining the data provided by attending medical staff regarding the component malfunctions. Working in tandem with medical staff, the engineers began a comprehensive disassembly of the patient’s prosthetic, with which they already had some familiarity due to improvised repairs and upgrades conducted at an earlier juncture. They discovered that numerous control components of the original prosthetic were severely damaged and began laboring to extract them in an attempt to save the existing unit. In the course of their repairs, the nature and extent of the damage to the patient’s nervous system became clear, which led the team to the conclusion that standard surgical approaches were insufficient. In an effort to provide an immediate, workable solution, the Engineering team approached the patient’s injuries in the same manner in which they’d approach shipboard damage control efforts - they attempted to bypass the damaged systems and reroute the nervous system control impulses. After performing a series of simulations to verify their hypothesis, the Engineering team began modifying a pair of subspace transceivers to serve as a replacement for the standard neuro-servo control interface that would not rely on the damaged brachial nerves. Subsequent assembly and testing was conducted rapidly and, post repairs, the patient was again able to manipulate her prosthetic effectively and without accidental input or injury.[4]
Discussion
The patient has since taken a leave of absence from active duty but after significant nervous system rehabilitation, follow-up consultations with her medical team point to a full integration with this new interface design with a significant improvement in neural feedback levels over the existing standard.
As the use of various types of prosthetic limbs becomes more extensive, the techniques and technologies employed in this case may be utilized, adapted, and developed to assist patients in maintaining their quality of life. As a result, we expect that Starfleet officers experiencing traumatic amputation in the line of duty will not face a mandatory reduction in their duties after successfully undergoing the above therapies.
Conclusion
While non-physically linked control of a prosthetic has been tested successfully in the past, limitations in micro-subspace transceiver design, bandwidth and power source have rendered experimental designs non-viable for implementation outside of controlled studies. This new design builds on several recent breakthroughs in multiple scientific and engineering disciplines which, if successful long term, could point the way to a completely new means for injured patients to interface with and control prosthetic appendages. The unconventional approach is readily adaptable to any extremity and may even serve in cases of plasma shock, neuro-electric cascade and other traumatic nervous system injuries.
References
- ↑ "Limbo (Veritas)" Starbase 118, Stardate 239601.12
- ↑ Gray, Henry. Anatomy of the Human Body. (1918).
- ↑ "History of the Myoelectric Arm" Ladha, Sanchit. History of the Myoelectric Arm.
- ↑ "SIM:JP: Lt. Teller, Lt. G'var, Lt. JG Ukinix, Lt. JG MacKenzie, and Ens. Vanlith: Helping Hands" Starbase 118, Stardate 239606.20