Electromyography system
First Claim
1. A method of determining at least one of a change in nerve status and a change in nerve proximity, comprising the steps of:
- (a) applying a first stimulus signal to a stimulus electrode located a distance from a nerve;
(b) detecting an EMG response generated by a muscle physiologically coupled to said nerve in response to said first stimulus signal;
(c) increasing said first stimulus signal and repeating steps (a) and (b) until said detected EMG response reaches a predetermined minimum EMG value representing an evoked muscle action potential;
(d) identifying the level of said first stimulus signal required to obtain said predetermined minimum EMG value;
(e) repeating steps (a) through (d) with a second stimulus signal to identify the level of said second stimulus signal required to obtain said predetermined minimum EMG value; and
(f) determining at least one of a change in nerve status and a change in nerve proximity based on a comparison of said first stimulus signal level and said second stimulus signal level required to obtain said predetermined minimum EMG value.
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Accused Products
Abstract
A method of determining relative neuro-muscular response onset value thresholds for a plurality of spinal nerves, comprising: depolarizing a portion of the patient'"'"'s cauda equina; and measuring the current intensity level at which a neuro-muscular response to the depolarization of the cauda equina is detected in each of the plurality of spinal nerves. A method for detecting the presence of a nerve adjacent the distal end of at least one probe, comprising: determining relative neuro-muscular response onset values for a plurality of spinal nerves; emitting a stimulus pulse from a probe or surgical tool; detecting neuro-muscular responses to the stimulus pulse in each of the plurality of spinal nerves; and concluding that the electrode disposed on the distal end of the at least one probe is positioned adjacent to a first spinal nerve when the neuro-muscular response detected in the first spinal nerve is detected as a current intensity level less than or equal to a corresponding neuro-muscular response onset value of the first spinal nerve.
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Citations
21 Claims
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1. A method of determining at least one of a change in nerve status and a change in nerve proximity, comprising the steps of:
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(a) applying a first stimulus signal to a stimulus electrode located a distance from a nerve;
(b) detecting an EMG response generated by a muscle physiologically coupled to said nerve in response to said first stimulus signal;
(c) increasing said first stimulus signal and repeating steps (a) and (b) until said detected EMG response reaches a predetermined minimum EMG value representing an evoked muscle action potential;
(d) identifying the level of said first stimulus signal required to obtain said predetermined minimum EMG value;
(e) repeating steps (a) through (d) with a second stimulus signal to identify the level of said second stimulus signal required to obtain said predetermined minimum EMG value; and
(f) determining at least one of a change in nerve status and a change in nerve proximity based on a comparison of said first stimulus signal level and said second stimulus signal level required to obtain said predetermined minimum EMG value. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. An article of manufacture for use in determining at least one of a change in nerve status and a change in nerve proximity, the article of manufacture comprising computer readable storage media including program logic embedded therein that causes control circuitry to perform the steps of:
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(a) applying a first stimulus signal to a stimulus electrode located a distance from a nerve;
(b) detecting an EMG response generated by a muscle physiologically coupled to said nerve in response to said first stimulus signal;
(c) increasing said first stimulus signal and repeating steps (a) and (b) until said detected EMG response reaches a predetermined minimum EMG value representing an evoked muscle action potential;
(d) identifying the level of said first stimulus signal required to obtain said predetermined minimum EMG value;
(e) repeating steps (a) through (d) with a second stimulus signal to identify the level of said second stimulus signal required to obtain said predetermined minimum EMG value; and
(f) determining at least one of a change in nerve status and a change in nerve proximity based on a comparison of said first stimulus signal level and said second stimulus signal level required to obtain said predetermined minimum EMG value. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. An apparatus for determining at least one of a change in nerve status and a change in nerve proximity, comprising:
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means for applying a first stimulus signal to a stimulus electrode located a distance from a nerve;
means for detecting an EMG response generated by a muscle physiologically coupled to said nerve in response to said first stimulus signal;
means for increasing said first stimulus signal until said detected EMG response reaches a predetermined minimum EMG value;
means for identifying the level of said first stimulus signal required to obtain said predetermined minimum EMG value;
means for applying a second stimulus signal to said stimulus electrode;
means for detecting an EMG response generated by a muscle physiologically coupled to said nerve in response to said second stimulus signal;
means for increasing said second stimulus signal until said detected EMG response reaches said predetermined minimum EMG value;
means for identifying the level of said second stimulus signal required to obtain said predetermined minimum EMG value; and
means for determining at least one of a change in nerve status and a change in nerve proximity based on a comparison of said first stimulus signal level and said second stimulus signal level required to obtain said predetermined minimum EMG value. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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Specification