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US 2010/0249644 A1Published application
System and Methods for Performing Dynamic Pedicle Integrity Assessements
AssigneeNuVasive, Inc.
InventorsPatrick Miles, Scot Martinelli, Jared Arambula, James Gharib, Allen Farquhar, Patrick Flanagan
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Abstract
The present invention involves systems and related methods for performing dynamic pedicle integrity assessments involving the use of neurophysiology.
Claims20
A method of delivering stimulation signals to patient tissue during surgery for monitoring neuromuscular evoked potentials, comprising the steps of:
- (a) attaching an electrical coupling mechanism having a plunger with an electrical contact surface electrically coupled to a stimulation source to a surgical instrument, (b) advancing the surgical instrument into the patient tissue;
- (b) applying a stimulation signal through the electrical coupling mechanism to the surgical instrument;
- and (c) monitoring to assess whether nerves are innervating as a result of the step of applying said stimulation signal.
A system for monitoring electromyographic (EMG) evoked potentials during surgery, comprising:
- a plurality of sensors that detect EMG responses from muscles associated with nerves located proximate to a surgical target site;
- an electrical coupling mechanism having a plunger with an electrical contact surface electrically coupled to a stimulation source and coupleable to a surgical instrument to deliver stimulation signals from the stimulation source to the surgical instrument;
- and
- a control unit in communication with the plurality of sensors and the stimulation source, the control unit being operable to (a) direct transmission of the stimulation signals;
- (b) receive voltage responses from the plurality of sensors, and (c) determine whether any of the nerves are innervating as a result of the step of applying the stimulation signals to the surgical instrument.
2 more elements
A system for performing pedicle integrity assessments, comprising:
- a surgical instrument for use in at least one of pedicle hole formation, hole preparation, and pedicle screw insertion at a pedicle target site, said pedicle target site in the general location of neural structures;
- an insulation member through which said surgical instrument is passed comprising a flexible hollow elongated sheath having a proximal end, a distal end, an interior lumen, and a substantially enclosed seal tip attached to said distal end of said hollow elongated member, wherein said seal tip includes an expandable aperture for receiving said surgical instrument;
- a sensor configured to detect a voltage response from muscles associated with said neural structures;
- and
- a control unit coupled to said medical instrument and the sensor, the control unit being configured to (a) transmit a stimulation signal to said surgical instrument, (b) receive a voltage response from the sensor, and (c) determine whether said neural structures are innervating as a result of the step of applying said application of stimulation signal to said surgical instrument.
2 more elements
Dependencies are inferred from the claim text.