# US 2024/0188967 A1 · Assemblies, systems, and methods for a neuromonitoring drill bit > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2024/0188967 A1 - Document ID: US20240188967A1 - Status: Published application - Kind: A1 - Application number: 18/584,407 - Filed: 2024-02-22 - Published: 2024-06-13 - Earliest claimed: 2021-10-08 - Assignees: NuVasive, Inc. - Applicants: NuVasive, Inc. - Inventors: Thomas Sweeney; John Love - Web page: https://patentgrep.com/patent/US20240188967A1 ## CPC - A61B 17/1633: {Sleeves, i.e. non-rotating parts surrounding the bit shaft, e.g. the sleeve forming a single unit with the bit shaft (A61B17/1644 takes precedence)} - A61B 90/04: {Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery (protection of eyes against laser radiation A61F9/022)} - A61B 5/40: {Detecting, measuring or recording for evaluating the nervous system (for sleep A61B5/4806; for anaesthesia A61B5/4821; for pain A61B5/4824)} - A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material} - A61B 17/1671: {for the spine} - A61B 5/389: Electromyography [EMG] - A61B 34/30: Surgical robots - A61B 2034/2055: {Optical tracking systems} - A61B 2090/08021: {of the patient or his organs} - A61B 2505/05: Surgical care - A61N 1/0551: {Spinal or peripheral nerve electrodes} - A61N 1/36062: {Spinal stimulation} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract Assemblies, systems, and methods are directed at a neuromonitoring bone drill bit. The assembly may include a surgical bone drill bit, a neuromonitoring connection in electrical communication with the drill bit, and a shield extending over a distal end of the drill bit. The shield may be configured to withdraw proximally as the drill bit is advanced into a subject's bone. The assembly may be connected to a surgical drill and used in a surgical spinal procedure. In operation, the assembly may be advanced to a subject's bone at a surgical site and the drill bit may rotate into the subject's bone. In response, the shield may engage the bone and the drill bit may be advanced with respect to the shield. The shield may electrically insulate tissue from electrical current passing through the drill bit as it is inserted at the surgical site. ## Claims ### Claim 1 A method comprising: providing a surgical assembly including: a surgical bone drill bit having a distal end portion and a proximal end portion, a neuromonitoring connection in electrical communication with the surgical bone drill bit, and a shield extending over the distal end portion of the surgical bone drill bit; and advancing the surgical bone drill bit into bone of the subject, wherein advancing the surgical bone drill bit into tissue of the subject causes the shield to withdraw proximally relative to the distal end portion as the surgical bone drill bit advances into the tissue of the subject. ### Claim 2 (depends on 1) The method of claim 1, wherein the shield is biased toward a distal end of the surgical bone drill bit. ### Claim 3 (depends on 1) The method of claim 1, wherein the shield includes teeth at a distal end of the shield. ### Claim 4 (depends on 1) The method of claim 1, wherein the surgical assembly further includes: a locking system in communication with the shield; and wherein the locking system is biased to a shield lock position and is configured to be secured in a shield unlock position relative to the surgical bone drill bit. ### Claim 5 (depends on 4) The method of claim 4, the locking system further including: an elongated member; a lock actuator configured to engage the elongated member and slide along the surgical bone drill bit; and one or more balls; and wherein the lock actuator has a lock position associated with the shield lock position and an unlock position associated with the shield unlock position and is configured to be secured in the unlock position. ### Claim 6 (depends on 5) The method of claim 5, wherein the surgical bone drill bit has a lumen having one or more openings at an axial location along the lumen, the one or more openings being configured to receive the one or more balls. ### Claim 7 (depends on 6) The method of claim 6, wherein the surgical assembly is configured such that the elongated member translates axially along the lumen when the lock actuator is actuated from the lock position to the unlock position to allow the shield to withdraw proximally. ### Claim 8 (depends on 6) The method of claim 6, wherein when the lock actuator is at the lock position to prevent the shield from withdrawing proximally, the elongated member extends within the lumen and positions the one or more balls within the one or more openings such that the one or more balls extend exterior of the surgical bone drill bit. ### Claim 9 (depends on 6) The method of claim 6, wherein a proximal end of the shield includes a taper configured to drive the one or more balls into the one or more openings and the lumen as the shield withdraws proximally. ### Claim 10 (depends on 6) The method of claim 6, wherein the surgical assembly is configured such that inertia of the surgical bone drill bit rotating causes the lock actuator to transition from the unlock position to the lock position once drilling stops or the surgical bone drill bit is reversed. ### Claim 11 (depends on 1) The method of claim 1, wherein the surgical assembly further includes: a drill bit sleeve extending along at least a portion of the surgical bone drill bit, wherein the drill bit sleeve and the shield electrically insulate a conductive path extending from the neuromonitoring connection to a distal end of the surgical bone drill bit; and wherein the drill bit sleeve is configured to receive a portion of the shield as the shield withdraws proximally. ### Claim 12 (depends on 11) The method of claim 11, wherein the surgical bone drill bit is configured to rotate relative to the drill bit sleeve and the shield. ### Claim 13 A method comprising: providing a surgical system including: a surgical bone drill bit having a distal end portion and a proximal end portion, a drill configured to receive the proximal end portion of the surgical bone drill bit, a neuromonitoring clip connected to a neuromonitoring connection on the surgical bone drill bit, a shield extending over the distal end portion of the surgical bone drill bit; and advancing the surgical bone drill bit into bone of the subject, wherein advancing the surgical bone drill bit into tissue of the subject causes the shield to withdraw proximally relative to the distal end portion as the surgical bone drill bit advances into the tissue of the subject. ### Claim 14 (depends on 13) The method of claim 13, wherein the surgical system further includes: a drill bit sleeve extending over the surgical bone drill bit at a location proximal to the shield, and wherein the drill bit sleeve is configured to receive the shield as the shield slides along the distal end portion of the surgical bone drill bit. ### Claim 15 (depends on 14) The method of claim 14, wherein the drill bit sleeve includes a concave contoured portion configured receiving a user's grip and the surgical bone drill bit is configured to rotate with respect to the concave contoured portion of the drill bit sleeve. ### Claim 16 (depends on 13) The method of claim 13, wherein the surgical system further includes: a locking system in communication with the shield; and wherein the locking system is biased to a lock position at which the shield is prevented from sliding along the distal end portion of the surgical bone drill bit; and wherein the locking system is configured to be secured in an unlock position relative to the surgical bone drill bit at which the shield is able to slide along the distal end portion of the surgical bone drill bit. ### Claim 17 (depends on 13) The method of claim 13, wherein the surgical system further includes: a navigable surgical sleeve; and wherein the navigable surgical sleeve defines a lumen configured to receive the surgical bone drill bit and the shield extending over the distal end portion of the surgical bone drill bit. ### Claim 18 (depends on 13) The method of claim 13, further comprising: withdrawing the surgical bone drill bit from the tissue of the subject, wherein withdrawing the surgical bone drill bit from the tissue of the subject causes the shield to advance distally over the distal end portion of the neuromonitoring bone drill bit. ### Claim 19 (depends on 18) The method of claim 18, further comprising: electrically stimulating the surgical bone drill bit with the neuromonitoring clip; and monitoring for a response to the stimulating indicative of a pedicle breach. ### Claim 20 (depends on 18) The method of claim 18, further comprising: disposing the surgical bone drill bit in a guide tube held by a robotic arm, and wherein the guide tube constrains positioning of the surgical bone drill bit while the neuromonitoring bone drill bit is advanced into bone of the subject.