Electromyography system
First Claim
1. A method for testing the structural integrity of a spinal pedicle of a patient through a minimally invasive operative corridor to detect a defect in the structural integrity of a pedicle wall surrounding a pedicle screw path formed through the pedicle, said method comprising:
- (a) advancing an elongate element to said pedicle via a minimally invasive approach through said patient;
(b) advancing a stimulation element through said elongate element to said pedicle, said stimulation element communicatively linked to a controller that directs application of an electrical stimulus;
(c) applying an electrical stimulus to said pedicle via said stimulation element;
(d) electrically monitoring with a sensor communicatively linked to said controller a muscle myotome associated with a spinal nerve lying adjacent to said pedicle to detect if an onset neuro-muscular response occurs in response to the application of said electrical stimulus;
(e) said controller automatically adjusting the magnitude of the electrical stimulus until said onset neuro-muscular response is detected, said controller determining the electrical stimulus magnitude that caused said onset neuro-muscular response;
(f) said controller interpreting the electrical stimulus magnitude which caused said onset neuro-muscular response and outputting an indicator indicative of the structural integrity of the pedicle; and
(g) redirecting the pedicle screw path when a defect in the structural integrity of the pedicle wall is indicated.
4 Assignments
0 Petitions
Accused Products
Abstract
Methods for determining structural integrity of a bone within the spine of a patient, the bone having a first aspect and a second aspect, wherein the second aspect separated from the first aspect by a width and located adjacent to a spinal nerve. The methods involve (a) applying an electrical stimulus to the first aspect of the bone; (b) electrically monitoring a muscle myotome associated with the spinal nerve to detect if an onset neuro-muscular response occurs in response to the application of the electrical stimulus to the first aspect of the bone; (c) automatically increasing the magnitude of the electrical stimulus to until the onset neuro-muscular response is detected; and (d) communicating to a user via at least one of visual and audible means information representing the magnitude of the electrical stimulus which caused the onset neuro-muscular response.
66 Citations
23 Claims
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1. A method for testing the structural integrity of a spinal pedicle of a patient through a minimally invasive operative corridor to detect a defect in the structural integrity of a pedicle wall surrounding a pedicle screw path formed through the pedicle, said method comprising:
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(a) advancing an elongate element to said pedicle via a minimally invasive approach through said patient; (b) advancing a stimulation element through said elongate element to said pedicle, said stimulation element communicatively linked to a controller that directs application of an electrical stimulus; (c) applying an electrical stimulus to said pedicle via said stimulation element; (d) electrically monitoring with a sensor communicatively linked to said controller a muscle myotome associated with a spinal nerve lying adjacent to said pedicle to detect if an onset neuro-muscular response occurs in response to the application of said electrical stimulus; (e) said controller automatically adjusting the magnitude of the electrical stimulus until said onset neuro-muscular response is detected, said controller determining the electrical stimulus magnitude that caused said onset neuro-muscular response; (f) said controller interpreting the electrical stimulus magnitude which caused said onset neuro-muscular response and outputting an indicator indicative of the structural integrity of the pedicle; and (g) redirecting the pedicle screw path when a defect in the structural integrity of the pedicle wall is indicated. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method for performing pedicle integrity assessments with minimal tissue disruption to detect a defect in the structural integrity of a pedicle wall surrounding a pedicle screw path formed through the pedicle, said method comprising:
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(a) advancing a minimally invasive cannula via a minimally invasive approach to a pedicle target site within a patient; (b) delivering a stimulation signal to said pedicle target site via a stimulation element disposed through said cannula, said stimulation element communicatively linked to a controller that directs application of the electrical stimulus; and (c) electrically monitoring with a sensor communicatively linked to said controller a muscle myotome innervated by a nerve adjacent to said pedicle to detect when an onset neuro-muscular response occurs in a muscle myotome innervated by said nerve in response to the delivery of said stimulation signal and determine the intensity level of the electrical stimulus that causes said onset neuro-muscular response; (d) said controller interpreting the determined intensity level of the electrical stimulus that caused said onset neuro-muscular response and outputting at least one of visual and audible indicia indicative of the structural integrity of the pedicle; and (e) redirecting the pedicle screw path when a defect in the structural integrity of the pedicle wall is indicated. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
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Specification