APPARATUS, SYSTEM, AND METHOD FOR MAPPING THE LOCATION OF A NERVE

• US 20120109004A1
• Filed: 10/27/2010
• Published: 05/03/2012
• Est. Priority Date: 10/27/2010
• Status: Active Grant

• Current Assignee: Cadwell Laboratories, Incorporated (Cadwell Industries Incorporated)
• Original Assignee: Cadwell Laboratories, Incorporated (Cadwell Industries Incorporated)
• Inventors: Cadwell, John
• Granted Patent: US 9,155,503 B2
• Time in Patent Office: Days
• US Class Current: 600/554
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/296 for electromyography [EMG]
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/395 Details of stimulation, e.g. nerve stimulation to elicit EMG response
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: A61B 6/5247 combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
• CPC Class Codes: A61B 8/5261 combining images from different diagnostic modalities, e.g. ultrasound and X-ray

Abstract

An apparatus, system, and method are disclosed for mapping the location of a nerve. The apparatus includes at least one stimulation module, a stimulation detection module, a distance module, and a mapping module. The stimulation module stimulates a nerve with an electrical stimulation current from at least one stimulation electrode. A stimulation detection module detects a muscle reaction resulting from stimulation of the nerve by the at least one stimulation electrode. The distance module uses information from the at least one stimulation electrode and from the stimulation detection module to calculate a distance between the at least one stimulation electrode and the nerve. The mapping module maps a location on the nerve using at least two distances calculated by the distance module and position information of the at least one stimulation electrode for each of the at least two distances calculated.

Claims

1. An apparatus to map the location of a nerve, the apparatus comprising:

a stimulation module that stimulates a nerve with an electrical stimulation current from at least one stimulation electrode;

a stimulation detection module that detects a muscle reaction, the muscle reaction resulting from stimulation of the nerve by the at least one stimulation electrode;

a distance module that uses information from the at least one stimulation electrode and from the stimulation detection module to calculate a distance between the at least one stimulation electrode and the nerve; and

a mapping module that maps a location on the nerve using at least two distances calculated by the distance module and position information of the at least one stimulation electrode for each of the at least two distances calculated.

2. The apparatus of claim 1, wherein the stimulation detection module comprises an electromyograph that detects an electrical potential generated by a muscle cell in response to stimulation of the nerve by the at least one stimulation electrode.

3. The apparatus of claim 1, wherein the at least two distances calculated by the distance module comprises at least three distances, each distance calculated indicating a spherical locus of potential sites on the nerve equidistant from a position of the at least one stimulation electrode when the at least one stimulation electrode stimulates the nerve, wherein the mapping module maps the location on the nerve by determining an intersection between the spherical locus of potential sites.

4. The apparatus of claim 3, wherein the at least one stimulation electrode comprises a first stimulation electrode, a second stimulation electrode, and a third stimulation electrode, the first stimulation electrode stimulating the nerve from a first position to calculate a first distance, the second stimulation electrode stimulating the nerve from a second position to calculate a second distance, the third stimulation electrode stimulating the nerve from a third position to calculate a third distance, the mapping module mapping a first location on the nerve using the first distance, the second distance, and the third distance.

5. The apparatus of claim 4, further comprising an electrode positioning module that moves at least one of the first stimulation electrode, the second stimulation electrode, and the third stimulation electrode to a new position, wherein at each new position of a stimulation electrode, the stimulation detection module, the distance module, and the mapping module determine one or more additional locations on the nerve.

6. The apparatus of claim 5, wherein the mapping module maps a route of the nerve using the one or more additional locations on the nerve.

7. The apparatus of claim 5, wherein the electrode positioning module moves the first stimulation electrode, the second stimulation electrode, and the third stimulation electrode.

8. The apparatus of claim 3, wherein the at least one stimulation electrode comprises one stimulation electrode and further comprising an electrode positioning module that positions the stimulation electrode in at least three positions to calculate at least three distances using the stimulation electrode, the stimulation detection module, and the distance module.

9. The apparatus of claim 8, wherein the electrode positioning module moves the stimulation electrode to a new position to determine one or more additional locations on the nerve using the stimulation electrode, the stimulation detection module, the distance module, and the mapping module.

10. The apparatus of claim 9, wherein the mapping module maps a route of the nerve using the one or more additional locations on the nerve.

11. The apparatus of claim 1, further comprising;

an imaging module that captures an image of a patient'"'"'s anatomy; and

an overlay module that overlays a map of the location on the nerve on the image of the patient'"'"'s anatomy captured by the imaging module, the map mapped by the mapping module.

12. The apparatus of claim 10, further comprising a marking module that marks a position of the at least one stimulation electrode with a marker comprising a material detectable by the imaging module, wherein the overlay module uses the marker to position the map of the location on the nerve on the image of the patient'"'"'s anatomy captured by the imaging module.

13. The apparatus of claim 11, wherein the imaging module captures a three dimensional image of the patient'"'"'s anatomy and wherein the overlay module overlays the map of the location on the nerve in three dimensions such that the location on the nerve within the patient'"'"'s anatomy is identified in three dimensions.

14. The apparatus of claim 11, wherein the imaging module comprises one or more of an imaging device selected from an x-ray device, a computerized axial tomography device, a magnetic resonance imaging device, and an ultrasound device.

15. An apparatus to map the location of a nerve, the apparatus comprising:

at least one stimulation electrode that stimulates a nerve with an electrical stimulation current from an electrical source;

a stimulation detection module that detects a muscle reaction, the muscle reaction resulting from stimulation of the nerve by the at least one stimulation electrode;

a distance module that uses information from the at least one stimulation electrode and from the stimulation module to calculate a distance between the at least one stimulation electrode and the nerve; and

an electrode positioning module that positions the at least one stimulation electrode in at least two positions to calculate at least two distances using the at least one stimulation electrode and the distance module;

a mapping module that maps a location on the nerve using at least two distances calculated by the distance module and position information of the at least one stimulation electrode for each of the at least two distance calculated.

16. The apparatus of claim 15, wherein each distance calculation indicates a spherical locus of potential sites of the nerve equidistant from a position of the at least one stimulation electrode when the at least one stimulation electrode stimulates the nerve, wherein the mapping module maps the location on the nerve by determining an intersection between the spherical locus of potential sites indicated by the at least two distances calculated by the distance module.

17. The apparatus of claim 15, further comprising;

an imaging module that captures an image of a patient'"'"'s anatomy; and

an overlay module that overlays a map of the location on the nerve on the image of the patient'"'"'s anatomy captured by the imaging module, the map mapped by the mapping module.

20. The method of claim 17, further comprising;

capturing an image of a patient'"'"'s anatomy; and

overlaying a map of the location on the nerve on the image of the patient'"'"'s anatomy.

18. A method for mapping the location of a nerve, the method comprising:

stimulating a nerve with a stimulation current from at least one stimulation electrode;

detecting a muscle reaction, the muscle reaction resulting from stimulation of the nerve by the at least one stimulation electrode;

calculating a distance between the at least one stimulation electrode and the nerve using current information from the at least one stimulation electrode at a time of first detecting the muscle reaction; and

mapping a location on the nerve using at least two distances calculated and position information of the at least one stimulation electrode for each of the at least two distances calculated.

19. The method of claim 18, wherein the at least two distances calculated comprises at least three distances, each of the at least three distances calculated indicates a spherical locus of potential sites on the nerve equidistant from a position of the at least one stimulation electrode when the at least one stimulation electrode stimulates the nerve, and wherein the location on the nerve is determined by determining an intersection between the spherical locus of potential sites indicated by the at least three distances.