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Publication Number
US-10478096-B2
Publication Date
2019-11-19
Expiration Date
Abstract
A neural monitoring system for detecting an artificially-induced mechanical muscle response to an electrical stimulus at a stimulation frequency includes a mechanical sensor and a processor in communication with the mechanical sensor. The mechanical sensor is configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle. The processor is configured to receive the mechanomyography output signal from the mechanical sensor and determine a frequency component of the mechanomyography output signal that has a peak magnitude and to detect the occurrence of an artificially-induced mechanical muscle response therefrom.
Core Innovation
The invention provides a non-invasive neural monitoring system for detecting an artificially-induced mechanical response of a muscle to an electrical stimulus provided within an intracorporeal treatment area of a human subject. The intracorporeal treatment area includes a nerve that innervates the muscle, and the system uses a non-invasive mechanical sensor configured to be placed in mechanical communication with the muscle to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle. A processor receives the mechanomyography output signal and analyzes it to identify frequency content related to the electrical stimulation.
The processor converts the mechanomyography output signal from a time domain to a frequency domain to determine a frequency component with a peak magnitude relative to adjacent frequencies or to determine a fundamental frequency of the mechanomyography output signal. The system provides an indication to a user of an artificially-induced mechanical muscle response when the determined frequency component or the determined fundamental frequency is either equal to the stimulation frequency or an integer multiple of the stimulation frequency. In embodiments, the determined frequency component is evaluated by its frequency-domain peak magnitude relative to adjacent frequencies.
Additional criteria support the indication of an artificially-induced mechanical muscle response, including evaluating whether the determined frequency component is within a range of greater than 0 Hz to about 20 Hz and/or whether the peak magnitude is above an established noise floor by a threshold amount. The document also describes stimulated detection by correlation with the stimulus frequency and free-running detection by inferring an induced response via expected frequency ranges and/or noise-floor thresholding, with an alert provided to a user.
Claims Coverage
The partial set contains three independent claims (clm-00001, clm-00010, clm-00018). Each independent claim centers on detecting an artificially-induced mechanical muscle response using a non-invasive mechanomyography sensor and processor frequency analysis, with user indication based on equality or integer multiple relative to the stimulation frequency.
Frequency component peak detection relative to stimulation frequency
A neural monitoring system comprising a non-invasive mechanical sensor in mechanical communication with a muscle to generate a mechanomyography output signal and a processor configured to receive the mechanomyography output signal, determine a frequency component of the mechanomyography output signal with a peak magnitude relative to adjacent frequencies, and provide an indication of an artificially-induced mechanical muscle response to a user if the determined frequency component is either equal to, or an integer multiple of, the stimulation frequency.
Fundamental frequency determination relative to stimulation frequency
A neural monitoring system comprising a non-invasive mechanical sensor in mechanical communication with a muscle to generate a mechanomyography output signal and a processor configured to receive the mechanomyography output signal, determine a fundamental frequency of the mechanomyography output signal, and provide an indication of an artificially-induced mechanical muscle response to a user if the determined fundamental frequency is either equal to, or an integer multiple of, the stimulation frequency.
Frequency component validation using low-frequency range and noise-floor threshold
A neural monitoring system comprising a non-invasive mechanical sensor in mechanical communication with a muscle to generate a mechanomyography output signal and a processor configured to receive the mechanomyography output signal, determine a frequency component of the mechanomyography output signal with a peak magnitude relative to adjacent frequencies, provide an indication of an artificially-induced mechanical muscle response to a user if the determined frequency component is either equal to, or an integer multiple of, the stimulation frequency, and either the determined frequency component is within the range of greater than 0 Hz to about 20 Hz or the peak magnitude is above an established noise floor by a threshold amount.
Across the independent claims, the core inventive coverage is frequency-domain analysis of a mechanomyography output signal from a non-invasive mechanical sensor in mechanical communication with a muscle. Each claim provides a user indication when a frequency result either is equal to or an integer multiple of the stimulation frequency, and one claim adds validation using a low-frequency range and/or noise-floor threshold.
Stated Advantages
Provides an indication of an artificially-induced mechanical muscle response to a user based on frequency relationships to the stimulation frequency.
Supports detection/indication using validation criteria including whether a determined frequency component is within a specified low-frequency range and whether the peak magnitude exceeds an established noise floor by a threshold amount.
Documented Applications
Use during intracorporeal procedures including robotic surgical feedback, where mechanomyography feedback is used to indicate or avoid nerve proximity [procedural detail omitted for safety].
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