Safeop Surgical, Inc.

Nuvasive, Inc.

Alphatec Spine, Incorporated

Robert Snow

Richard A O'Brien

James E Gharib

Gregg Johns

Eric Finley

An automated evoked potential analysis apparatus for improved monitoring, detecting and identifying changes to a patient's physiological system is described. The apparatus includes an input device for obtaining electrical potential data from the patient's physiological system after application of stimulation to a patient's nerve and a computing system for receiving and analyzing the electrical potential data. The computing system includes a processing circuit configured to: generate a plurality of evoked potential waveforms (EPs) based on the electrical potential data, measure changes or trends in the generated EPs utilizing a sliding window of analysis, display incremental changes in waveforms between full subsets of EPs, and determine an alert vote for each subset, representative of changes to the physiological system generating the EPs.

System, method, and computer algorithm for measuring, displaying, and accurately detecting changes in electrophysiological evoked potentials

A medical method of automatically improving signals received from a patient's physiological system can include delivering stimulation signals to a nerve pathway of a patient with electrical pulses via electrodes placed over the nerve pathway to generate a plurality of resultant electrical waveforms (EPs) based on a plurality of electrophysiological responses (ERs); recording the plurality of resultant EPs; generating an ensemble average waveform (EA), the generating comprising averaging a subset of the plurality of ERs; and denoising the EA, the denoising comprising applying a wavelet transform to the EA.

Medical systems and methods for detecting changes in electrophysiological evoked potentials

A method for determining a lowest stimulation threshold current level in a group of channels of a neuromonitoring device. The method includes stimulating tissue at a current level from a predetermined range of current levels as a sequence of pulses delivered at a frequency. The stimulating includes increasing the current level of each pulse in the sequence of pulses from an immediately preceding pulse by a first current increment. The method includes determining that a first evocation pulse from the sequence of pulses evokes a first muscular response. The method includes stimulating the tissue with a second evocation pulse from the sequence of pulses to evoke a second muscular response. The stimulating includes decreasing the frequency of the delivery of each pulse in the sequence of pulses and increasing the current level of each pulse in the sequence of pulses from the immediately preceding pulse by a second current increment. The method includes determining that the second evocation pulse from the sequence of pulses evokes the second muscular response.

Systems, methods, and devices for detecting the threshold of nerve-muscle response using variable frequency of stimulation

A method of optimally placing spinal cord stimulator (SCS) leads includes acquiring components of somatosensory evoked potentials (SSEPs), compound action potentials and triggered EMG; analyzing the waveforms; and quantifying waveform features in a single display such that a surgeon can quickly and easily determine optimal placement (as it relates to laterality and level of placement on the spinal cord) of SCS leads in a patient under general anesthesia without additional expert help.

Systems and methods for placement of spinal cord stimulator leads

Devices and methods for stimulation and recording of muscle responses for determining degree of neuromuscular blockade, particularly relevant to elicitation of such responses in those under the influence of anesthesia. A system for estimating the degree of neuromuscular blockade includes at least one stimulating electrode, at least one recording electrode, a pulse generator for providing stimulation to a nerve through the stimulating electrode, and a computing device configured to: apply stimuli to the nerve according to a stimulation protocol, wherein the stimulation protocol provides a plurality of stimulation sequences that vary in frequency of pulses in the stimulation sequence, frequency of the stimulation sequences, number of pulses in the stimulation sequence, or all of the above; measure, by the recording electrode, electrical responses of a muscle; and estimate the degree of neuromuscular blockade based on changes in the electrical responses of the muscle during a stimulation sequence.

Device and means of assessing neuromuscular junction status with higher fidelity

This disclosure describes a surgical instrument comprising a combination femoral nerve localizer and needle placement guide instrument. The instrument may be used with a neuromonitoring system to localize and monitor the femoral nerve during a spinal procedure.

Systems and methods for performing neurophysiologic monitoring during spine surgery

A surgical access system comprising a tissue retraction assembly equipped with two or more electrodes for use in monitoring the status of nearby neural structures, including the localized depth of neural structures relative to one or more components of the tissue retraction assembly. Additional neurological testing may be performed to monitor the health and status of the neural structures during the portions of the surgical procedure in which the tissue retraction assembly is used to maintain the operative corridor.

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Phoenix, MD, United States of America

Robert Snow