Intraoperative neural monitoring method
Inventors
Wybo, Christopher • Nay, David S. • Scarfe, Darren P. • Scarfe, Lukas T. • O'Neil, Samantha J. • Gordon, Gary
Assignees
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Publication Number
US-11980476-B1
Publication Date
2024-05-14
Expiration Date
Abstract
A method for detecting an artificially induced neuromuscular response in a subject includes receiving a mechanomyography (MMG) output signal from a mechanical sensor in contact with a muscle of the subject; applying one or more conditioning filters to the MMG output signal to generate a conditioned signal and analyzing the conditioned signal to identify one or more candidate waveforms. Each candidate waveform meets one or more analog or digital signal characteristic criteria associated with an artificially induced neuromuscular response. The method then compares a first candidate waveform to a second candidate waveform to determine a degree of similarity between the first and second candidate waveforms, and provides an alert to a user that indicates detection of the artificially induced neuromuscular response when the degree of similarity exceeds a predetermined threshold.
Core Innovation
The invention provides an intraoperative neural monitoring system and methods for detecting an artificially induced neuromuscular response in a subject using a mechanomyography (MMG) output signal. A mechanical sensor in contact with a muscle provides the MMG signal, and one or more conditioning filters are applied to generate a conditioned signal for analysis. The conditioned signal is analyzed to identify one or more candidate waveforms that meet one or more analog or digital signal characteristic criteria associated with the artificially induced neuromuscular response.
The method further compares a first candidate waveform to a second candidate waveform to determine a degree of similarity between the candidate waveforms. An alert is provided to a user that indicates detection of the artificially induced neuromuscular response when the degree of similarity exceeds a predetermined threshold. In addition, the method can analyze the MMG signal by identifying candidate waveforms meeting signal criteria indicative of a neuromuscular response, and then uses waveform-to-waveform similarity as a basis for detection and alerting.
In a surgical monitoring context, the invention also supports monitoring health of a nerve during a surgical procedure by positioning an electrode in contact with the nerve and transmitting an electrical stimulus via the electrode. The electrical stimulus includes a current exceeding a threshold current known to induce an artificially induced neuromuscular response, and MMG output from a muscle innervated by the nerve is received and analyzed to identify candidate waveforms and determine waveform similarity relative to a predetermined threshold. The invention further determines a minimum electrical stimulus current required to induce a candidate waveform meeting the one or more signal criteria, and compares the minimum electrical stimulus current to a known threshold stimulation current to assess health of the nerve.
Claims Coverage
The partial content includes three independent claims (clm-00001, clm-00018, clm-00021), centered on similarity-based detection of an artificially induced neuromuscular response using conditioned MMG signals and waveform criteria, and on using threshold stimulation current comparisons to assess nerve health during surgery.
Conditioned MMG candidate waveform similarity detection with alert threshold
A method for detecting an artificially induced neuromuscular response by receiving an MMG output signal from a mechanical sensor, applying one or more conditioning filters to generate a conditioned signal, identifying candidate waveforms meeting signal characteristic criteria, comparing a first candidate waveform to a second candidate waveform to determine a degree of similarity, and providing an alert when the degree of similarity exceeds a predetermined threshold.
Electrodes and MMG sensing system for similarity-based neuromuscular response alerting
A system including one or more electrodes configured to transmit electrical stimuli to tissue and one or more sensors configured to output an MMG signal in response to muscle activity, where a processor receives the MMG signal, analyzes it to identify candidate waveforms meeting signal criteria, determines a degree of similarity between a first and a second candidate waveform, and provides an alert when the degree of similarity exceeds a predetermined threshold to indicate detection of the artificially induced neuromuscular response.
Nerve health monitoring using similarity threshold and minimum stimulus current comparison
A method for monitoring health of a nerve during a surgical procedure by positioning an electrode in contact with the nerve, transmitting an electrical stimulus with a current exceeding a threshold current known to induce an artificially-induced neuromuscular response, receiving an MMG output signal from a mechanical sensor in contact with a muscle innervated by the nerve, analyzing the MMG to identify a first candidate waveform and a second candidate waveform, determining that a degree of similarity between the candidate waveforms exceeds a predetermined threshold, determining a minimum electrical stimulus current required to induce a candidate waveform meeting the signal criteria, and comparing the minimum electrical stimulus current to a known threshold stimulation current to assess health of the nerve.
Across the independent claims, the core coverage is similarity-based detection of an artificially induced neuromuscular response using conditioned MMG signals and candidate waveform criteria, implemented either as a method or as a system with electrodes and MMG sensors that generates an alert when similarity exceeds a predetermined threshold. The nerve-health independent claim extends the detection approach with minimum electrical stimulus current determination and comparison to a known threshold stimulation current to assess nerve health.
Stated Advantages
Provides an alert to a user indicating detection of the artificially induced neuromuscular response when waveform similarity exceeds a predetermined threshold.
Assesses health of the nerve during a surgical procedure by comparing a determined minimum electrical stimulus current to a known threshold stimulation current.
Documented Applications
Intraoperative neural monitoring using MMG-based detection of an artificially induced neuromuscular response.
Nerve health monitoring during a surgical procedure using MMG waveform analysis and comparison of minimum stimulus current to a known threshold stimulation current.
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