Nerve surveillance cannula systems
First Claim
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1. A method of accessing an intervertebra splace while protecting adjacent spinal nerves, comprising:
- advancing a cannula through a patient'"'"'s facia and para-spinal musculature, the cannula comprising an expandable tip with a plurality of nerve sensing electrodes disposed thereon;
sensing the presence of a nerve with the nerve sensing electrodes;
inserting a slidable member though the cannula to open the expandable tip of the cannula; and
removing the slidable member from the expandable tip cannula, thereby providing a cannulated access to the intervertebral space through the expandable tip cannula.
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Abstract
An expandable tip cannula system, comprising: a hollow cannula shaft having a proximal end and a distal end; and an expandable tip mounted at the distal end of the hollow cannula shaft, the expandable tip comprising a plurality of generally-triangular shaped petals held together in a radially-inwardly tapered arrangement between adjacent petals, each petal comprising a nerve sensing electrode disposed therein.
607 Citations
11 Claims
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1. A method of accessing an intervertebra splace while protecting adjacent spinal nerves, comprising:
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advancing a cannula through a patient'"'"'s facia and para-spinal musculature, the cannula comprising an expandable tip with a plurality of nerve sensing electrodes disposed thereon;
sensing the presence of a nerve with the nerve sensing electrodes;
inserting a slidable member though the cannula to open the expandable tip of the cannula; and
removing the slidable member from the expandable tip cannula, thereby providing a cannulated access to the intervertebral space through the expandable tip cannula. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
sensing the axial position of the nerve relative to the expandable tip cannula.
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4. The method of claim 1, wherein sensing the presence of a nerve with the nerve sensing electrodes, comprises:
sensing the radial position of the nerve relative to the expandable tip cannula.
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5. The method of claim 1, wherein, the cannula is inserted percutaneously.
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6. The method of claim 2, wherein, the cannula is inserted posterolateraly.
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7. The method of claim 1, further comprising,
avoiding an adjacent spinal nerve by moving the cannula in a direction away from the nerve. -
8. The method of claim 1, further comprising,
activating the electrodes to cauterize blood vessels.
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9. A method of providing a passageway to a patient'"'"'s intervertebral space, comprising:
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advancing a nerve surveillance probe in a cannula towards said patient'"'"'s intervertebral space, sensing the presence of a nerve with at least one electrode disposed on said nerve surveillance probe;
expanding an expandable covering disposed over said cannula;
receiving a second cannula over said expandable covering after said expanded covering is in an expanded position; and
removing said nerve surveillance probe and expandable covering from within said second cannula thereby providing a passageway to said intervertebral space. - View Dependent Claims (11)
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10. A nerve surveillance system, comprising:
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a first cannula having an expandable distal end;
a second cannula received within said first cannula and dimensioned such that, when slidably advanced through said first cannula, said expandable distal end of said first cannula will open; and
an obturator received within said second cannula, said obturator having a centrally disposed nerve surveillance electrode disposed proximate to a distal end thereof, said nerve surveillance electrode being equipped to deliver energy in an amount sufficient for nerve surveillance and in an amount insufficient to ablate or cauterize tissue.
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Specification