Emergence of Nerve Interfaces with Robotic Applications

Innovations in the fields of prosthetic devices and neuroprosthetic control strategies have opened new frontiers for optimizing functional restoration for people suffering from limb loss. Commercial prosthetic devices are now available with sophisticated electrical and mechanical components that can closely replicate the functions of the human musculoskeletal system. However, to truly recognize the potential of such prosthetic devices and develop the next generation of bionic limbs, a highly reliable prosthetic device control strategy is required. In the past few years, refined surgical techniques have enabled neuroprosthetic control strategies to record efferent motor and stimulate afferent sensory action potentials from a residual limb with extraordinary specificity, signal quality, and long-term stability. As a result, such control strategies are now capable of facilitating intuitive, real-time, and naturalistic prosthetic experiences for patients with amputations. This article describes regenerative peripheral nerve interfaces (RPNI) and targeted muscle reinnervation (TMR), the two most promising surgical procedures to enhance prosthetic rehabilitation with the goal of providing a prosthetic device that looks, moves, and feels like a normal hand. In this manuscript, we will also discuss how both of these surgical approaches have been shown to effectively prevent and treat neuroma pain and phantom limb pain in patients with limb loss. Two landmark papers have been selected to highlight the management of neuroma pain and phantom limb pain in patients with limb loss. Three landmark papers have been selected to demonstrate the newest peripheral nerve interface strategies to optimize prosthetic function following amputation.