Systems and methods for dynamic neurophysiological stimulation
OwnerMelissa Kirkup, Richard A. Villarreal +1inventors
InventorsMelissa Kirkup, Richard A. Villarreal, John A. Cadwell, Jr.
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Abstract
An intraoperative neurophysiological monitoring (IONM) system for identifying and assessing neural structures comprises at least one probe, at least one reference electrode, at least one strip or grid electrode, at least one sensing electrode, and a stimulation module. Threshold responses determined by stimulation during a surgical procedure are used to identify and assess functionality of neural structures. The identified neural structures are avoided and preserved while diseased or damaged tissue is resected during said surgical procedure.
Claims23
A method of using cortical stimulation to assess neural structures during a surgical procedure, the method comprising:
- providing an intraoperative neurophysiological monitoring (IONM) system comprising at least one probe, at least one reference electrode, at least one strip electrode or grid electrode, at least one sensing electrode, a stimulation module and a handle having a proximal end configured to connect to the stimulation module and a distal end configured to attach to the at least one probe, wherein the handle comprises a first visual indicator, a second visual indicator, and an actuator configured to automatically switch the stimulation module between a first mode of operation and a second mode of operation depending upon a type of the at least one probe, and wherein the first mode of operation is a bipolar mode and the second mode of operation is a monopolar mode;
- placing the at least one reference electrode in a perimeter of a surgical field of a patient;
- positioning the at least one probe and/or the at least one strip electrode or grid electrode at target locations on the anatomy of said patient;
- preparing for recordation of said patient's responses to stimulation by positioning said at least one sensing electrode on said patient's anatomy;
- initiating a stimulation protocol in accordance with the automatically selected first mode of operation or second mode of operation;
- adjusting stimulation parameters of the stimulation protocol to determine a threshold response;
- and
- assessing the neural structures based on said threshold response, wherein assessing comprises determining whether the patient's anatomy is functioning in a manner indicative of an underlying disease.
A method of using direct nerve stimulation to identify nerve fibers and nerve pathways during a surgical procedure, the method comprising:
- providing an intraoperative neurophysiological monitoring (IONM) system comprising at least one probe, at least one sensing electrode, a stimulation module, and a handle having a proximal end configured to connect to the stimulation module and a distal end configured to attach to the at least one probe, wherein the stimulation module comprises at least twelve output connectors and a plurality of probe ports, wherein the handle comprises a first visual indicator, a second visual indicator, and an actuator configured to automatically switch the stimulation module between a first mode of operation and a second mode of operation depending upon a type of the at least one probe, and wherein the first mode of operation is a bipolar mode and the second mode of operation is a monopolar mode;
- positioning the at least one probe at a first target location on the patient;
- positioning the at least one sensing electrode at a second target location in the patient;
- initiating a direct nerve stimulation protocol in accordance with the automatically selected first mode of operation or second mode of operation;
- adjusting stimulation parameters of the direct nerve stimulation protocol to determine a threshold motor response;
- and
- identifying the nerve fibers and nerve pathways based on the threshold motor response.
Dependencies are inferred from the claim text.