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Publication Number
US-12478312-B1
Publication Date
2025-11-25
Expiration Date
Abstract
A method for assessing nerve health during a surgical procedure includes: applying one or more electrical stimuli proximate to the target nerve during the surgical procedure; detecting a muscle response evoked by the one or more electrical stimuli; determining at least one nerve function parameter indicative of the health or function of the target nerve; identifying a target range for the at least one nerve function parameter adapted for the target nerve, the target range being predictive of a desired nerve health status of the target nerve; and outputting an indication of the determined at least one nerve function parameter relative to the identified target range to provide real-time feedback during the surgical procedure involving the target nerve.
Core Innovation
The invention relates to intraoperative neural monitoring during a surgical procedure involving a target nerve of a subject. A stimulator applies one or more electrical stimuli proximate to the target nerve during the surgical procedure, and a sensor detects a muscle response evoked by the electrical stimuli. The muscle response originates from a muscle innervated by the target nerve, enabling the system to assess nerve health or function during the procedure.
Based on the detected muscle response, a processor determines a value of at least one nerve function parameter indicative of the health or function of the target nerve. The processor identifies a target range for the value of the at least one nerve function parameter, where the target range is predictive of a desired nerve health status of the target nerve. The target range is based, at least in part, on an attribute of the subject, a comorbidity of the subject, and/or an assessment of a pre-operative neurological function of the subject or the target nerve.
The processor outputs, for presentation on a display device, an indication of the determined value relative to the identified target range to provide real-time feedback during the surgical procedure involving the target nerve. In representative implementations, the target range can be probabilistic and can be identified using a database storing historical outcomes data, including a subset of similar patients and nerve function parameters associated with successful outcomes. The system uses the monitored nerve function parameter value to indicate whether the desired nerve health status is being approached.
Additional aspects include refining the sensed muscle response using a mechanomyography (MMG) sensor and associated signal generation. The at least one nerve function parameter can include at least one of a minimum stimulation threshold required to evoke a detectable muscle response, a supramaximal stimulation threshold required to evoke a maximal muscle response, and a magnitude of the maximal muscle response. The monitored output is configured to support intraoperative decision feedback in surgical contexts such as tumor resection proximate to a critical nerve or peripheral nerve decompression procedures.
Claims Coverage
The document contains two independent claims, directed to a method and to a system for assessing nerve health during a surgical procedure involving a target nerve. Across the independent claims, the inventive coverage centers on electrical stimulation proximate to the target nerve, sensor detection of an evoked muscle response from a muscle innervated by the target nerve, determining at least one nerve function parameter indicative of nerve health or function, and identifying and using a subject-/assessment-based predictive target range to provide real-time display feedback.
Intraoperative stimulation and evoked muscle response sensing
Applying, via a stimulator controlled by the processor, one or more electrical stimuli proximate to the target nerve during the surgical procedure; and detecting, by a sensor communicatively coupled to the processor, a muscle response evoked by the one or more electrical stimuli, the muscle response originating from a muscle innervated by the target nerve.
Determining nerve function parameter from the detected muscle response
Determining, by the processor based on the detected muscle response, a value of at least one nerve function parameter indicative of the health or function of the target nerve.
Predictive target range based on subject attributes and pre-operative assessment
Identifying, by the processor, a target range for the value of the at least one nerve function parameter, wherein the target range is predictive of a desired nerve health status of the target nerve and is based, at least in part, on an attribute of the subject, a comorbidity of the subject, and/or an assessment of a pre-operative neurological function of the subject or the target nerve.
Real-time feedback by relative display of parameter value versus target range
Outputting, by the processor for presentation on a display device, an indication of the determined value of the at least one nerve function parameter relative to the identified target range to provide real-time feedback during the surgical procedure involving the target nerve.
The independent claims cover an intraoperative nerve health assessment framework where electrical stimulation near a target nerve is followed by sensing an evoked muscle response, computing at least one nerve function parameter, and comparing that parameter to a predictive, subject-/assessment-based target range for real-time display feedback.
Stated Advantages
Provides real-time feedback during the surgical procedure involving the target nerve.
Documented Applications
Intraoperative nerve health assessment during spinal decompression surgery involving a target nerve.
Tumor resection performed proximate to the target nerve, where the target nerve is a critical nerve structure and the target range is indicative of preserved nerve function.
Peripheral nerve decompression procedures including at least one of a carpal tunnel release procedure or a cubital tunnel release procedure.
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