System and methods for determining nerve proximity, direction, and pathology during surgery
First Claim
Patent Images
1. A method of establishing an operative corridor for spinal surgery, comprising:
- mounting a plurality of EMG electrodes proximate to selected leg muscles;
activating a nerve monitoring system that outputs a stimulation current signal to one or more surgical access instruments and that, in response to signals from the EMG electrodes, displays neuromuscular response information which is indicative of nerve proximity;
advancing a plurality of sequential dilator cannulas through bodily tissue having neural structures in a selected path toward a targeted intervertebral disc of a spine, each of the sequential dilator cannulas having at least one stimulation electrode that delivers the stimulation signal to the bodily tissue before reaching the spine;
during advancement of each respective sequential dilator cannula through the bodily tissue, viewing the neuromuscular response information on a display device of the nerve monitoring system for an indication of nerve proximity when the stimulation signal is delivered to the bodily tissue from the respective sequential dilator cannula;
advancing a working corridor instrument over an outermost dilator cannula of the plurality of sequential dilator cannulas toward the targeted intervertebral disc of the spine; and
establishing an operative corridor to the targeted intervertebral disc of the spine using the working corridor instrument.
4 Assignments
0 Petitions
Accused Products
Abstract
The present invention involves systems and methods for determining nerve proximity, nerve direction, and pathology relative to a surgical instrument based on an identified relationship between neuromuscular responses and the stimulation signal that caused the neuromuscular responses.
256 Citations
21 Claims
-
1. A method of establishing an operative corridor for spinal surgery, comprising:
-
mounting a plurality of EMG electrodes proximate to selected leg muscles; activating a nerve monitoring system that outputs a stimulation current signal to one or more surgical access instruments and that, in response to signals from the EMG electrodes, displays neuromuscular response information which is indicative of nerve proximity; advancing a plurality of sequential dilator cannulas through bodily tissue having neural structures in a selected path toward a targeted intervertebral disc of a spine, each of the sequential dilator cannulas having at least one stimulation electrode that delivers the stimulation signal to the bodily tissue before reaching the spine; during advancement of each respective sequential dilator cannula through the bodily tissue, viewing the neuromuscular response information on a display device of the nerve monitoring system for an indication of nerve proximity when the stimulation signal is delivered to the bodily tissue from the respective sequential dilator cannula; advancing a working corridor instrument over an outermost dilator cannula of the plurality of sequential dilator cannulas toward the targeted intervertebral disc of the spine; and establishing an operative corridor to the targeted intervertebral disc of the spine using the working corridor instrument. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
-
Specification