Multi-channel stimulation threshold detection algorithm for use with neurophysiology monitoring systems

A neuromonitoring system for performing multi-channel neurophysiologic assessments, comprising:

• a stimulator configured to deliver at least one electrical stimulation signal to a patient;
• at least one sensor adapted to be coupled to a myotome, said sensor configured to detect a neuromuscular response evoked by said electrical stimulation signal;
• and
• a control unit in communication with said stimulator and said at least one sensor, said control unit being configured to:
• determine a threshold current level on a first channel of the neuromonitoring system based on a delivery of stimulation signals, via the stimulator, and an analysis of neuromuscular responses on said first channel, via the at least one sensor, to determine when the stimulation signals evoke a significant neuromuscular response, wherein the threshold current level is a stimulation current level at which a nerve tissue depolarizes, said first channel associated with a first myotome, wherein the significant neuromuscular response comprises a peak-to-peak voltage that is greater than a threshold voltage corresponding to the threshold current level, wherein said stimulation signals are delivered as a sequence of pulses and wherein a current level of each pulse is adjusted from an immediately preceding pulse until the threshold current level required to evoke the significant neuromuscular response is determined;
• and
• omit one or more pulses from the sequence of pulses when the neuromuscular response to an omitted pulse is predictable based upon data obtained, at the control unit, during determination of the threshold current level of the first channel, wherein the data obtained comprises one or more stimulation current levels corresponding to the delivered stimulation signals.