Neurophysiological apparatus and procedures
First Claim
1. A method for determining the direction of a pedicle breach during hole formation, comprising the steps of:
- advancing an instrument having a proximal end and a distal end, said distal end terminating at a distal tip, wherein said distal tip is collinear with said proximal end and configured for advancement into a pedicle, said distal tip having an electrode arranged along a single side;
rotating said instrument about a longitudinal axis extending between said proximal end and said distal tip during pilot hole formation while simultaneously applying a stimulation signal to said instrument, wherein said pilot hole extends between an outer surface of said pedicle and an interior location within said pedicle; and
determining the direction of said breach by monitoring neuromuscular responses to successive stimulation signals during the rotation of said instrument.
4 Assignments
0 Petitions
Accused Products
Abstract
Neurophysiological instruments and techniques are improved through various enhancements. Stimulation of an instrument is possible while it is advancing into the spine or elsewhere, alerting the surgeon to the first sign the instrument or device (screw) may be too near a nerve. A directional probe helps surgeons determine the location of the hole in the pedicle. Electrically insulating sleeves prevent shunting into the soft tissues. According to a different improvement, the same probe to be used to stimulate different devices, such as screws and wires. Electrical impulses may be recorded from non-muscle regions of the body, including the spine and other portions of the central nervous system as opposed to just the extremities.
-
Citations
11 Claims
-
1. A method for determining the direction of a pedicle breach during hole formation, comprising the steps of:
-
advancing an instrument having a proximal end and a distal end, said distal end terminating at a distal tip, wherein said distal tip is collinear with said proximal end and configured for advancement into a pedicle, said distal tip having an electrode arranged along a single side; rotating said instrument about a longitudinal axis extending between said proximal end and said distal tip during pilot hole formation while simultaneously applying a stimulation signal to said instrument, wherein said pilot hole extends between an outer surface of said pedicle and an interior location within said pedicle; and determining the direction of said breach by monitoring neuromuscular responses to successive stimulation signals during the rotation of said instrument. - View Dependent Claims (2, 3, 4, 5, 6)
-
-
7. A method for determining directionality during surgery, comprising the steps of:
-
advancing an instrument into a pedicle target site, said instrument having a proximal end and a distal end terminating at a distal tip collinear with said proximal end and configured for advancement into said pedicle and having an electrode arranged along a single side of said distal tip; and rotating said instrument about a longitudinal axis extending between said proximal end and said distal and simultaneously transmitting an electrical signal to a nerve adjacent said pedicle from a neurophysiology monitoring system communicatively linked to said instrument to determine the direction of a breach detected in said pedicle during pilot hole formation, wherein said pilot hole extends from an outer surface of the pedicle bone to the pedicle target site in the interior of the pedicle. - View Dependent Claims (8, 9, 10, 11)
-
Specification