Intraoperative neural monitoring system utilizing wavelet-based event detection
Inventors
Wybo, Christopher • Nay, David S. • Scarfe, Darren P. • Scarfe, Lukas T. • O'Neil, Samantha J.
Assignees
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Publication Number
US-11980474-B1
Publication Date
2024-05-14
Expiration Date
Abstract
An intraoperative neural monitoring system for use during a surgical procedure on a subject includes a mechanical sensor and a processor. The mechanical sensor is configured to monitor a physical motion of a muscle of the subject and provide a mechanomyography (MMG) signal corresponding to the monitored physical motion. The processor is configured to receive the MMG signal, apply a wavelet transform to the MMG signal, and determine, from the output of the wavelet transform, if the monitored physical motion of the muscle is an artificially induced neuromuscular response that is attributable to an applied electrical stimulus. If the processor determines that the monitored physical motion of the muscle is an artificially induced neuromuscular response, it then provides an indication to a user.
Core Innovation
The invention provides an intraoperative neural monitoring system for use during a surgical procedure on a subject. The system includes a selectively electrifiable nerve stimulator configured to apply an electrical stimulus to a nerve or nerve root during the surgical procedure, and the electrical stimulus includes a plurality of discrete electrical pulses, each pulse spaced from a previously administered pulse by a stimulation period. The nerve stimulator includes an elongate body with a handle and/or handle connector at a proximal end portion and a stimulator tip at a distal end portion, with the handle connector and stimulator tip being electrically conductive and in electrical communication with each other, and an exterior surface between them being non-conductive.
The system further includes a mechanical sensor configured to monitor physical motion of a muscle of the subject and provide a mechanomyography (MMG) signal corresponding to the monitored physical motion. A processor receives the MMG signal and performs wavelet-based analysis by computing, for each wavelet of a plurality of wavelets, a convolution coefficient representative of a degree of similarity between the MMG signal and the wavelet, and consolidates the computed convolution coefficients into a single net-convolution coefficient at each of a plurality of sequential timesteps.
The processor identifies a plurality of peaks within the net-convolution coefficient, with each peak spaced in time from a previously identified peak by a time period. The processor determines that the physical motion is an artificially induced neuromuscular response attributable to the applied electrical stimulus if the time period between identified peaks matches the stimulation period between administered electrical pulses, and provides an indication to a user if it is determined that the monitored physical motion is an artificially induced neuromuscular response.
Claims Coverage
The document includes one independent claim describing the core system and its wavelet-based synchronization test, with dependent claims adding refined stimulator geometry and additional determination outputs or alternative matching strategies. The independent claim contains four inventive features that jointly enable pulse-period synchronization detection using MMG and wavelet convolution, followed by an output indication.
Intraoperative neural monitoring system with selectively electrifiable nerve stimulator
An intraoperative neural monitoring system comprising a selectively electrifiable nerve stimulator for applying an electrical stimulus to a nerve or nerve root during a surgical procedure, the nerve stimulator including an elongate body with a handle or handle connector at a proximal end portion and a stimulator tip at a distal end portion, conductive handle connector and stimulator tip in electrical communication, an exterior surface non-conductive between the connector and the tip, and an exposed electrode operative to apply the electrical stimulus; the applied electrical stimulus comprises a plurality of discrete electrical pulses each spaced by a stimulation period.
MMG-based muscle motion monitoring
A mechanical sensor configured to monitor physical motion of a muscle of the subject and provide a mechanomyography (MMG) signal corresponding to the monitored physical motion.
Wavelet convolution to form net-convolution coefficient and peak timing
A processor configured to receive the MMG signal, compute a convolution coefficient for each wavelet representative of similarity between the MMG signal and the wavelet, consolidate the computed convolution coefficients into a single net-convolution coefficient at sequential timesteps, identify a plurality of peaks within the net-convolution coefficient each spaced by a time period, and determine the physical motion is an artificially induced neuromuscular response attributable to the applied electrical stimulus if the time period between identified peaks matches the stimulation period between administered electrical pulses.
User indication for artificially induced neuromuscular response
The processor provides an indication to a user if it is determined that the monitored physical motion of the muscle is an artificially induced neuromuscular response.
Across the independent claim’s feature set, the system applies discrete electrical pulses with a stimulation period, measures MMG from monitored muscle motion, uses wavelet convolution to form a net-convolution coefficient and identify peaks, and confirms artificial neuromuscular response by matching peak spacing to the stimulation period, followed by a user indication.
Stated Advantages
Documented Applications
No documented applications found
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