System and methods for performing dynamic pedicle integrity assessments
First Claim
Patent Images
1. A method for performing pedicle integrity assessments, comprising the steps of:
- (a) establishing electrical communication between a stimulation element and an interior of a pedicle hole with an electrical coupling mechanism having a plunger with an electrical contact surface electrically coupled to a stimulation source during at least one of pilot hole formation, pilot hole preparation, and pedicle screw introduction;
(b) applying a stimulation signal to said stimulation element; and
(c) monitoring to assess whether nerves adjacent said pedicle are innervating as a result of the step of applying said application of stimulation signal to said stimulation element.
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Abstract
The present intention involves systems and related methods for performing dynamic pedicle integrity assessments involving the use of neurophysiology.
260 Citations
22 Claims
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1. A method for performing pedicle integrity assessments, comprising the steps of:
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(a) establishing electrical communication between a stimulation element and an interior of a pedicle hole with an electrical coupling mechanism having a plunger with an electrical contact surface electrically coupled to a stimulation source during at least one of pilot hole formation, pilot hole preparation, and pedicle screw introduction; (b) applying a stimulation signal to said stimulation element; and (c) monitoring to assess whether nerves adjacent said pedicle are innervating as a result of the step of applying said application of stimulation signal to said stimulation element. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A system for performing pedicle integrity assessments, comprising:
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a medical instrument for use in at least one of pedicle hole formation, hole preparation, and pedicle screw insertion at a pedicle target site, said pedicle target site in the general location of neural structures; a sensor configured to detect a voltage response from muscles associated with said neural structures; control unit coupled to said medical instrument and the sensor, the control unit being configured to (a) transmit a stimulation signal to said medical instrument, (b) receive a voltage response from the sensor, and (c) determine whether said neural structures are innervating as a result of the step of applying said application of stimulation signal to said medical instrument; and an electrical coupling mechanism having a plunger with an electrical contact surface electrically coupled to said control unit for coupling said medical instrument to said control unit. - View Dependent Claims (8, 9, 10, 11, 12)
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13. A method for performing pedicle integrity assessments, comprising the steps of:
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(a) providing an insulation member through which a stimulation element is passed, the insulation member comprising a flexible hollow elongated sheath having a proximal end, a distal end, an interior lumen, and a substantially enclosed seal tip attached to said distal end of said hollow elongated member, wherein said seal tip includes an expandable aperture for receiving said stimulation element; (b) establishing electrical communication between a stimulation element and an interior of a pedicle hole with an electrical coupling mechanism having a plunger with an electrical contact surface electrically coupled to a stimulation source during at least one of pilot hole formation, pilot hole preparation, and pedicle screw introduction; (c) applying a stimulation signal to said stimulation element; and (d) monitoring to assess whether nerves adjacent said pedicle are innervating as a result of the step of applying said application of stimulation signal to said stimulation element. - View Dependent Claims (14, 15, 16, 17)
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18. A system for performing pedicle integrity assessments, comprising:
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a medical instrument for use in at least one of pedicle hole formation, hole preparation, and pedicle screw insertion at a pedicle target site, said pedicle target site in the general location of neural structures; an insulation member through which said medical instrument is passed comprising a flexible hollow elongated sheath having a proximal end, a distal end, an interior lumen, and a substantially enclosed seal tip attached to said distal end of said hollow elongated member, wherein said seal tip includes an expandable aperture for receiving said medical instrument; a sensor configured to detect a voltage response from muscles associated with said neural structures; a control unit coupled to said medical instrument and the sensor, the control unit being configured to (a) transmit a stimulation signal to said medical instrument, (b) receive a voltage response from the sensor, and (c) determine whether said neural structures are innervating as a result of the step of applying said application of stimulation signal to said medical instrument; and
an electrical coupling mechanism having a plunger with an electrical contact surface electrically coupled to said control unit for coupling said medical instrument to said control unit. - View Dependent Claims (19, 20, 21, 22)
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Specification