Neuromonitoring systems and methods
AssigneeCadwell Laboratories, Inc.
InventorJohn Cadwell
Life of this patent
Estimating the term…
Abstract
Systems, devices, and methods are described for neuromonitoring. A minimum stimulus signal required to elicit a threshold neuromuscular response is determined by delivery of stimulus signals to tissue and detection of neuromuscular responses in muscle tissue. The strength of the delivered stimulus signals is varied, for example by adjusting the current amplitude or pulse width of the signals, and muscle responses are measure, for example by detecting EMG signals. The delivered stimuli and corresponding responses are then used to determine a stimulation threshold. The stimulation threshold may be used to indicate at least one of nerve proximity and pedicle integrity.
Claims32
A neuromonitoring system comprising:
- a surgical instrument for delivering stimulus signals to tissue including or adjacent to a nerve;
- and
- a processing subsystem in data communication with the surgical instrument comprising:
- a detection module configured to detect, in muscle tissue, a first neuromuscular response in response to a first stimulus signal having a first pulse width and to detect a second neuromuscular response in response to a second stimulus signal having a second pulse width;
- a processing module in communication with the detection module and configured to determine a stimulation threshold for the nerve from the first stimulus signal, the second stimulus signal pulse, the first neuromuscular response, and the second neuromuscular response, wherein the stimulation threshold comprises at least a minimum pulse width required to elicit a neuromuscular response greater than or equal to a predetermined threshold and wherein the stimulation threshold has a pulse width that is different from the first and second pulse widths;
- and
- a communication module in communication with the processing module and configured to communicate an indicator of the stimulation threshold to indicate at least one of nerve proximity or pedicle integrity.
The neuromonitoring system of 4, wherein the sensing electrode comprises a surface EMG electrode.
A neuromonitoring system comprising:
- a surgical accessory having at least one stimulation electrode;
- a processing subsystem configured to:
- stimulate the at least one stimulation electrode with a first electrical stimulation signal having a first pulse and a second electrical stimulation signal having a second pulse;
- measure a first neuromuscular response and a second neuromuscular response caused by the first electrical stimulation signal and the second electrical stimulation signal depolarizing one or more nerves;
- automatically determine a stimulation threshold of the one or more nerves by automatically adjusting a pulse width of at least one of the first electrical stimulation signal or the second electrical stimulation signals, wherein a pulse width of the stimulation threshold is different from the pulse width of the at least one of first electrical stimulation signal or the second electrical stimulation signal;
- and
- a communication module configured to communicate to a user an indication of the stimulation threshold to indicate at least one of nerve proximity or pedicle integrity.
Dependencies are inferred from the claim text.