Deformity correction using neural integrity monitoring
First Claim
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1. A method comprising:
- engaging a bone anchor to a location on a vertebral body when the vertebral body is in a first orientation;
coupling the bone anchor with a correction tool;
manipulating the correction tool to move the vertebral body toward a second orientation with the bone anchor;
electrically monitoring the bone anchor with a nerve monitoring system that provides an electrical signal that travels through the correction tool to the bone anchor to detect interference between a neural element and the bone anchor while the vertebral body is moved toward the second orientation; and
retaining the vertebral body in the second orientation by coupling a connecting element to the bone anchor and an implant engaged to a second vertebral body, the connecting element being spaced apart from the implant while the correction tool is manipulated to move the vertebral body.
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Abstract
A method is provided for detecting neural interference between a bone anchor and a neural element during or subsequent to the application of force on the bone anchor to adjust the orientation of one or more vertebral bodies relative to the spinal column. The method includes engaging at least one bone anchor to the vertebral body and applying force to the bone anchor to adjust the positioning or orientation of the vertebral body. A nerve monitoring system provides an electrical signal and is operable to detect a neural element and its proximity to the bone anchor as a function of a characteristic of the electrical signal.
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Citations
24 Claims
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1. A method comprising:
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engaging a bone anchor to a location on a vertebral body when the vertebral body is in a first orientation; coupling the bone anchor with a correction tool; manipulating the correction tool to move the vertebral body toward a second orientation with the bone anchor; electrically monitoring the bone anchor with a nerve monitoring system that provides an electrical signal that travels through the correction tool to the bone anchor to detect interference between a neural element and the bone anchor while the vertebral body is moved toward the second orientation; and retaining the vertebral body in the second orientation by coupling a connecting element to the bone anchor and an implant engaged to a second vertebral body, the connecting element being spaced apart from the implant while the correction tool is manipulated to move the vertebral body. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 21, 22)
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12. A surgical method comprising:
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forming a bone anchor hole at a first location into a vertebral body of a spinal column; engaging a bone anchor to the vertebral body in the bone anchor hole; coupling a correction tool with the bone anchor; coupling a nerve monitoring system to the correction tool; applying force to the bone anchor with the correction tool to change an orientation of the vertebral body relative to the spinal column while detecting for interference between a neural element and the bone anchor with the nerve monitoring system; detecting interference between the neural element and the bone anchor with the nerve monitoring system by providing an electrical signal from the nerve monitoring system that travels through the correction tool and the bone anchor; applying force to at least one of a second location on the vertebral body with the correction tool to move the spinal column from a first orientation to a second orientation after detecting interference between the neural element and the bone anchor; and retaining the spinal column in the second orientation by coupling a connecting element to the bone anchor and an implant engaged to a second vertebral body, the connecting element being spaced apart from the implant while the correction tool applies force to move the spinal column to the second orientation. - View Dependent Claims (13, 14, 15)
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16. A method comprising:
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preparing a bony tissue area of a vertebra for reception of a bone anchor when the vertebra is in a first position; electrically coupling a nerve monitoring system to a bone anchor driver; engaging the bone anchor with the bone anchor driver to engage the bone anchor to the prepared bony tissue area of the vertebra while providing an electrical signal to the bone anchor through the bone anchor driver; detecting a neural element threshold as a function of the electrical signal with the nerve monitoring system while engaging the bone anchor to the bony tissue area; engaging the bone anchor with a correction tool; electrically coupling the correction tool with the nerve monitoring system; moving the correction tool while engaged to the bone anchor to change an orientation of the vertebra to a second position from the first position; providing an electrical signal through the correction tool to the bone anchor to detect a neural element threshold as a function of the electrical signal with the nerve monitoring system while changing the orientation of the vertebra; and fixing the vertebra at the second position with a connecting element anchored to the bone anchor and extending to a second bone anchor engaged to a second vertebra, the connecting element being spaced apart from the second bone anchor as the correction tool moves the vertebra to the second position. - View Dependent Claims (17, 18, 19, 20)
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23. A method comprising:
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engaging a bone anchor to a location on a vertebral body when the vertebral body is in a first orientation; coupling the bone anchor with a connecting element; coupling the connecting element with a correction tool; manipulating the correction tool to move the vertebral body toward a second orientation with the connecting element; and electrically monitoring the bone anchor with a nerve monitoring system that provides an electrical signal that travels through the correction tool to the bone anchor to detect interference between a neural element and the bone anchor while the vertebral body is moved toward the second orientation, wherein manipulating the correction tool comprises applying a rotational force to the correction tool which rotates the correction tool and correspondingly rotates the vertebral body toward the second orientation. - View Dependent Claims (24)
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Specification