Systems and methods for intra-operative regional neural stimulation
First Claim
1. A method of avoiding nerve tissue in a surgical procedure, the method comprising the steps of:
- identifying a first potential incision location and a first potential incision length;
in a first application step, applying a first electrical stimulation, with an electrode, to a first tissue region along the first potential incision length;
during the first application step, observing a neural response to the first stimulation;
identifying a second incision location and a second potential incision length;
in a second application step, applying a second electrical stimulation, with the electrode, to a second tissue region along the second potential incision length;
during the second application step, observing no neural response to the second stimulation; and
after observing no neural response to the second stimulation, performing a surgical procedure through the second tissue region.
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Accused Products
Abstract
Systems and methods according to the present invention provide a means for determining, as an example, the health or location of nerves. Generally, embodiments according to the present invention may be used to verify the absence of nerve tissue along a prospective incision location to avoid damage caused by such incision. Alternatively or additionally, embodiments according to the present invention may be used to locate and/or hone in on a more precise location of one or more nerves. Electrical stimulation may be applied to tissue in an iterative fashion in one or more desired patterns and at one or more stimulation intensities to determine one or more regional neural responses and one or more focused neural responses.
70 Citations
39 Claims
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1. A method of avoiding nerve tissue in a surgical procedure, the method comprising the steps of:
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identifying a first potential incision location and a first potential incision length; in a first application step, applying a first electrical stimulation, with an electrode, to a first tissue region along the first potential incision length; during the first application step, observing a neural response to the first stimulation; identifying a second incision location and a second potential incision length; in a second application step, applying a second electrical stimulation, with the electrode, to a second tissue region along the second potential incision length; during the second application step, observing no neural response to the second stimulation; and after observing no neural response to the second stimulation, performing a surgical procedure through the second tissue region. - View Dependent Claims (2, 3, 4, 5, 6, 14, 15, 36)
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7. A method of locating nerve tissue to perform a surgical procedure, the method comprising the steps of:
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identifying a first potential incision location and a first potential incision length; in a first application step, applying a first electrical stimulation, with an electrode, to a tissue region along the first potential incision length; during the first application step, observing no desired neural response to the first stimulation; altering a parameter of the electrical stimulation; in a second application step, applying a second stimulation to the tissue region; during the second application step, observing a desired neural response to the second stimulation; after the first and second application steps, making an incision along the first potential incision length; performing a surgical procedure through the incision; in a third application step, applying the first stimulation to the tissue region, observing the desired neural response during the third application step. - View Dependent Claims (8, 9, 10, 11, 12, 13, 37)
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16. A method for honing in on nerve fibers disposed below or innervating animal tissue, the method comprising the steps of:
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at a first stimulation intensity, applying a first electrical stimulation to animal tissue within an identified stimulation region, the first electrical stimulation being applied with an electrode in contact with the tissue; in a first identifying step, identifying a plurality of first active stimulation locations within the stimulation region at which one or more neural response is generated in response to the first electrical stimulation, the first active stimulation locations being disposed about a perimeter of a focused stimulation region; at a reduced stimulation intensity, applying a second electrical stimulation within the focused stimulation region; and in a second identifying step, identifying a second active stimulation location within the focused stimulation region at which one or more neural response is generated in response to the second electrical stimulation. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 38)
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27. A method of seeking a neural response to electrical stimulation, the method comprising the steps of:
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identifying a prospecting location on animal tissue; applying electrical stimulation to the tissue at the prospecting location with an electrode to determine whether a neural response is generated; observing no neural response to the electrical stimulation, translating the electrode in contact with the tissue radially outward from the prospecting location in a first direction for a first honing distance; observing no neural response to the electrical stimulation, translating the electrode in a second direction back to the prospecting location; translating the electrode radially outward from the prospecting location in a third direction for a second honing distance; and observing a neural response to the electrical stimulation. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34, 35, 39)
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Specification