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Publication Number
US-8882679-B2
Publication Date
2014-11-11
Expiration Date
Abstract
A neural monitoring system for detecting an induced response of a muscle to a stimulus provided within an intracorporeal treatment area of a human subject includes a mechanical sensor 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, and a receiver in communication with the mechanical sensor. The receiver is configured to: receive the mechanomyography output signal from the mechanical sensor; compute a time derivative of the sensed muscle movement from the mechanomyography output signal; compare the computed time derivative to a threshold; and indicate that the sensed mechanical movement of the muscle was induced by the provided intracorporeal stimulus if the computed time derivative exceeds the threshold.
Core Innovation
The invention is a neural monitoring system for detecting an induced response of a muscle to a stimulus provided within an intracorporeal treatment area of a human subject. The intracorporeal treatment area includes a nerve that innervates the muscle. The system includes a 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 receiver in communication with the mechanical sensor receives the mechanomyography output signal and computes a time derivative of the sensed muscle movement from the mechanomyography output signal. The receiver compares the computed time derivative to a first threshold and indicates that the sensed mechanical movement was induced by the provided intracorporeal stimulus if the computed time derivative exceeds the first threshold.
In further described implementations, a receiver determines a magnitude of acceleration of the muscle from the mechanomyography output signal and determines a magnitude of the provided intracorporeal stimulus. The receiver uses the stimulus magnitude and the muscle acceleration magnitude to determine a proximity between the stimulator and the nerve, compares the determined proximity to a second threshold, and provides an alert if the determined proximity is less than the second threshold and the computed time derivative exceeds the first threshold.
Claims Coverage
The document contains three independent claims covering a neural monitoring system and a method. Across the independent claims, four main inventive elements are repeatedly used: mechanomyography signal generation, time-derivative thresholding for induced response indication, optional proximity determination using stimulus magnitude and muscle acceleration, and proximity/time-derivative thresholding for alert generation.
Mechanomyography sensor for intracorporeal induced-response detection
A mechanical sensor 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 stimulus is provided within an intracorporeal treatment area including a nerve that innervates the muscle.
Time-derivative threshold indication of induced movement
A receiver configured to receive the mechanomyography output signal, compute a time derivative of the sensed muscle movement from the mechanomyography output signal, compare the computed time derivative to a first threshold, and indicate that the sensed mechanical movement of the muscle was induced by the provided intracorporeal stimulus if the computed time derivative exceeds the first threshold.
Stimulus-and-acceleration proximity determination and second-threshold alerting
A receiver configured to determine a magnitude of acceleration of the muscle from the mechanomyography output signal; determine a magnitude of the provided intracorporeal stimulus; determine a proximity between the stimulator and the nerve from the magnitude of the provided intracorporeal stimulus and the magnitude of acceleration of the muscle; compare the determined proximity to a second threshold; and provide an alert if the determined proximity is less than the second threshold and the computed time derivative exceeds the first threshold.
The independent claim set covers detecting an induced muscle response by using mechanomyography to compute a time derivative and applying a first-threshold decision, and further supports deriving stimulator-to-nerve proximity from stimulus magnitude and muscle acceleration to apply a second-threshold decision that triggers an alert when proximity is below the second threshold while the time-derivative exceeds the first threshold.
Stated Advantages
Not explicitly described in patent.
Documented Applications
Not explicitly described in patent.
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