Intraoperative neurophysiological monitoring system

• US 9,949,651 B2
• Filed: 10/31/2012
• Issued: 04/24/2018
• Est. Priority Date: 11/01/2011
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Stone, Corbett, Vaughan, Robin, Gambhir, Kabir
• Primary Examiner(s): CERIONI, DANIEL LEE
• Application Number:
  US14/355,816
• Publication Number:
  US 20150032022A1
• Time in Patent Office: 2,001 Days
• Field of Search: 600554
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin

Abstract

A surgical system kit is described. The surgical system kit includes a peripheral electrode, a surgical access instrument configured to be placed in a surgical target site, and a control unit. The surgical access instrument has a body with a proximal end, and a distal end, two or more electrodes on the distal end at fixed locations and spaced apart a known distance. The control unit is configured to send a signal to the peripheral electrode, receive information indicative of a neural response from at least one electrode of the surgical access instrument, and interpret the information according to a nerve conduction velocity modality to measure the nerve conduction velocity through the segment of the nerve.

Claims

1. A surgical system kit, comprising:

a surgical access instrument having a body configured to form an operative corridor at a surgical target site within a patient;

a first electrode and a second electrode configured to be placed proximate to a nerve path of a nerve within the patient, one of the first electrode and the second electrode configured to apply a physical agent and another one of the first electrode and the second electrode configured to receive a neural response from the patient, the first electrode and the second electrode being on an outer surface of the body of the surgical access instrument spaced a predetermined distance apart and located for contacting nerve-containing tissue;

one or more patient modules configured to be connected to the first and second electrodes and configured to stimulate one of the first and second, electrodes and receive information indicative of the neural response from a segment of the nerve path proximate to the first and second electrodes from another one of the first and second electrodes; and

a control unit configured to be coupled to the one or more patient modules, receive the information indicative of the neural response from the segment of the nerve path proximate to the first electrode and the second electrode on the outer surface of the body of the surgical access instrument, and interpret the information according to a nerve conduction velocity modality to determine the nerve conduction velocity of the segment of the nerve.

2. The surgical system kit of claim 1 further comprising a ground electrode and a third electrode, the ground electrode configured to be placed between the surgical access instrument and the third electrode.

3. The surgical system kit of claim 1, wherein the predetermined distance is from 0.5 cm to 2 cm from the first electrode to the second electrode, and wherein the surgical access instrument is a dilator.

4. The surgical system kit of claim 1, wherein the predetermined distance is from 0.5 cm to 2 cm from the first electrode to the second electrode, and wherein the surgical access instrument is a probe.

5. The surgical system kit of claim 1, wherein the predetermined distance is from 0.5 cm to 2 cm from the first electrode to the second electrode, and wherein the surgical access instrument is a retractor, the retractor having one or more blades and wherein the first electrode and the second electrode are connected to an outer surface of one of the one or more blades.

6. The surgical system kit of claim 1, wherein at least one of the first and second electrode is formed from a flowable epoxy ink.

7. The surgical system kit of claim 1, wherein the first electrode is partially embedded in the surgical access instrument.

8. The surgical system kit of claim 1, wherein the first electrode is configured to generate an F-wave at the surgical target site to measure nerve conduction velocity when the second electrode stimulates a motor nerve.