Systems and Methods of Integrating Electrophysiological Data with a Visual Representation of Associated Electrodes and Contacts in a Patient-Specific Three-Dimensional Brain Model
A method of enabling a user to visualize, review and analyze a patient's EEG data, pre-surgical data and post-surgical data, includes generating a unified viewing environment, wherein the unified viewing environment has at least a first view area and a second view area; importing, using the unified viewing environment, pre-surgical data and post-surgical data; acquiring EEG data of the patient; displaying, simultaneously, the EEG data in the first view area and the post-surgical data in the second view area of the unified viewing environment, wherein the EEG data is displayed as a vertical stack of a plurality of EEG traces, and wherein the post-surgical data is displayed without a need to pre-process and co-register with a three-dimensional coordinate system; and automatically associating visual representation of each of one or more electrodes and contacts in the post-surgical data with an EEG trace of the plurality of EEG traces.
Systems, devices and methods are provided for neuromonitoring, particularly neuromonitoring to reduce the risks of contacting or damaging nerves or causing patient discomfort during and after surgical procedures, including spinal surgeries. The neuromonitoring procedures include monitoring for the presence of or damage to sensory nerves, and optionally includes additional monitoring for motor nerves. In some systems, including systems that monitor for both sensory and motor nerves, components of the monitoring systems (e.g., stimulating electrodes and response sensors), may be combined with one or more surgical instruments. The systems, devices, and methods provide for pre-surgical assessment of neural anatomy and surgical planning, intraoperative monitoring of nerve condition, and post-operative assessment of nerve position and health.
An integrated multi-modality system has a first modality corresponding to an EDX or physiological device, including associated amplifier and different types of stimulators, and a second modality corresponding to an US device, including associated probes and beam former, in data communication with a computing device. The system is configured to synchronize EDX and US devices for time-locked collection and analysis of both the EDX and US data thereby allowing combined functionality, review, and analysis. The system generates an integrated multi-modal data file that combines the processed EDX and/or physiological and US data into a unitary file with a singular format thereby supporting a plurality of clinical applications.
G16H 30/20 - ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
G16H 40/67 - ICT specially adapted for the management or administration of healthcare resources or facilitiesICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
4.
Systems and Methods for Generating Reference Limits for Use in Diagnostic and Monitoring Systems
In systems and methods for dynamically generating reference limits for use in a neuromonitoring system, a first set of neuromonitoring data from separate patient tests conducted by the neuromonitoring system is received. Each of the separate patient tests is associated with variables. Each of the variables is associated with a corresponding one of the first neuromonitoring data as metadata. The first set of neuromonitoring data is compiled with associated metadata into one or more reference limits. When neuromonitoring data is received from a second patient test, at least one analysis is applied to the second patient test using the one or more reference limits.
G16H 50/20 - ICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61B 5/388 - Nerve conduction study, e.g. detecting action potential of peripheral nerves
G16H 10/60 - ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
A training simulator for intraoperative neuromonitoring (IONM) systems includes channels where at least one of the channels is identified as an active stimulation channel and a subset of the rest of the channels is identified as reference or pick up sites. Channels of the subset having signal data that exceed a predefined threshold are retained for further processing, while channels with signal data that do not exceed the threshold are eliminated from further reporting. Response data for the remaining channels are generated in advance of a future time when the response would occur. The generated data is time stamped and stored for display at a time window when requested by the system.
A replaceable DIN connector receptacle is provided that may be removably attached to a connector board and coupled with medical equipment in the field, without requiring the connector board or the equipment in which the DIN connector receptacle is housed to be opened. The replaceable DIN connector receptacle allows easy service and maintenance of medical equipment in the field. Relative to convention, DIN connector(s) are removed from the housing of the remaining medical equipment, placed in its own separate housing that is dedicated to just housing the DIN connector(s), and placed in electrical communication with the medical equipment through a dedicated wired or wireless connection.
An intraoperative neurophysiological monitoring (IONM) system for identifying and assessing neural structures comprises at least one probe, at least one reference electrode, at least one strip or grid electrode, at least one sensing electrode, and a stimulation module. Threshold responses determined by stimulation during a surgical procedure are used to identify and assess functionality of neural structures. The identified neural structures are avoided and preserved while diseased or damaged tissue is resected during said surgical procedure.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
8.
Apparatus and Method for Polyphasic Multi-Output Constant-Current and Constant-Voltage Neurophysiological Stimulation
The present specification discloses an intraoperative neurophysiological monitoring (IONM) system including a computing device capable of executing an IONM software engine, a stimulation module having multiple ports and various stimulation components and recording electrodes. The system is used to implement transcranial electrical stimulation and motor evoked potential monitoring by positioning at least one recording electrode on a patient, connecting the stimulation components to at least one port on the stimulation module, positioning the stimulation components on a patient's head, activating, using the IONM software engine, at least one port, delivering stimulation to the patient; and recording a stimulatory response on the patient.
Systems and methods of enabling synchronization of a patient's EEG data with associated video and audio data for analysis in a computing device include a synchronization device which generates, synchronously, first data indicative of a first differential electrical signal, second data indicative of a second differential electrical signal, a plurality of visible light signals that are acquired by a video acquisition device to generate third data and a plurality of audio signals that are acquired by an audio acquisition device to generate fourth data. The computing device compares the first data with the third data to calculate a first time compensation, compares the second data with the fourth data to calculate a second time compensation and applies the first compensation time to the patient's video data and the second compensation time to the patient's audio data.
Systems, devices and methods for advanced electrode management in neurological monitoring applications include receiving sockets configured to receive connectors having groups of electrodes. The physician is not required to manually map each electrode with its corresponding input channel. Electrodes are coupled to the corresponding input channels in groups through connectors having a unique identification (ID). The system is configured to read the unique ID of each connector and establish its identity. Based on the ID, the system configures itself to automatically correlate or associate each electrode with its corresponding input channel when the connectors are first inserted into the receiving sockets, and again if the connectors are removed and re-inserted into different positions in the receiving sockets, to insure the electrodes are always mapped to the same input channels.
A system for deploying an electrode array at a target location through a hole formed in the patient's cranium. The system includes an array of electrodes attached to a substrate and an inserter attached to the substrate and/or the array of electrodes. The inserter, substrate and array of electrodes are configured into a first compressed state and are positioned within the lumen of a cannula. Using the cannula, the system is inserted through the hole, the cannula is then removed, and the inserter is used to transition the substrate and electrode array from the first compressed state to a second uncompressed state, thereby deploying the array of electrodes at the target location.
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
A61B 1/313 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopesIlluminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
A61B 5/06 - Devices, other than using radiation, for detecting or locating foreign bodies
Methods of performing diagnostic tests on electroencephalography (EEG) recording devices comprising at least one stimulator coupled with a plurality of EEG electrode recording channels and corresponding recording channel connectors are performed by a test fixture comprising a plurality of resistors coupled with one or more of the EEG electrode recording channels and corresponding recording channel connectors. The methods include performing an impedance test for determining if each EEG recording channel of the EEG recording device has a predefined impedance, performing a channel uniqueness test for each EEG recording channel, performing a test for verifying the state of a switch of the stimulator of the EEG recording device, and performing a test for verifying connector IDs of the recording channel connectors connecting the EEG electrodes to respective EEG recording channels.
A connector receptacle for connecting with a corresponding connector plug coupled with electrodes being used for performing EMG procedure on a patient is provided. The receptacle includes a first ball bearing pressing against a first end of a housing of the plug and, preferably, a second ball bearing pressing against a first end of the housing of the plug when the plug is connected to the receptacle for exerting a retention force against the plug. The first and the second ball bearings are pressed against the first and the second ends respectively by using a spring force generated, for example, by a retention band.
Systems, devices and methods are described for mounting medical equipment on IV poles, bed rails and other supporting structures in medical facilities including operating rooms and critical care sections. A system including a mounting hanger and corresponding equipment housing is disclosed that allows quick mounting and dismounting of equipment from a supporting structure. The novel structural design of mounting hanger including a symmetrical t-slot feature and a plunger lock allows a piece of equipment to be mounted on a supporting structure in multiple orientations as per the requirement which allows a user to optimize the placement of equipment in the medical environment.
F16M 11/08 - Means for attachment of apparatusMeans allowing adjustment of the apparatus relatively to the stand allowing pivoting around a vertical axis
F16M 13/02 - Other supports for positioning apparatus or articlesMeans for steadying hand-held apparatus or articles for supporting on, or attaching to, an object, e.g. tree, gate, window-frame, cycle
15.
System and Method of Assessing a Patient's Visual Function
A system for assessing a patient's visual function includes a first set of electrodes positioned on the patient's scalp, a head-mounted device having a frame with a left eye element, a right eye element, and a bridge coupling the eye elements, light sources accommodated within each of the eye elements, a second set of electrodes integrated in the head-mounted device, and a computing device. When the computing device triggers the one or more light sources to deliver visual stimuli to at least one of patient's eyes, the first set of electrodes records first data and the second set of electrodes record second data. The data is interpreted to differentiate between actual biological causes for visual defects and technical anomalies causing absent or abnormal data in the vision assessment procedure.
A system for EEG data acquisition and presentation includes a neuromonitoring medical system for capturing electrical activity of a patient's brain as EEG signals via EEG electrodes, a server coupled with the neuromonitoring medical system for processing the captured EEG signals and transmitting the processed EEG signals, and a client device for receiving and displaying the processed EEG signals for viewing by a clinician. The server includes modules for paginating EEG signals into data pages of compressed EEG data, binning the paginated EEG data into groups of predefined frequencies, analyzing the binned EEG data to determine signals of interest, and marking the signals of interest with predefined signal markers. The client device enables the clinician to stop the display upon encountering a signal marker and display windows containing low resolution EEG signals in the vicinity of the EEG data containing the signal marker.
Systems, devices and methods are described for mounting medical equipment on IV poles, bed rails and other supporting structures in medical facilities including operating rooms and critical care sections. A system including a mounting hanger and corresponding equipment housing is disclosed that allows quick mounting and dismounting of equipment from a supporting structure. The novel structural design of mounting hanger including a symmetrical t-slot feature and a plunger lock allows a piece of equipment to be mounted on a supporting structure in multiple orientations as per the requirement which allows a user to optimize the placement of equipment in the medical environment.
F16M 11/08 - Means for attachment of apparatusMeans allowing adjustment of the apparatus relatively to the stand allowing pivoting around a vertical axis
F16M 13/02 - Other supports for positioning apparatus or articlesMeans for steadying hand-held apparatus or articles for supporting on, or attaching to, an object, e.g. tree, gate, window-frame, cycle
18.
Integrated Electrodiagnostic and Ultrasound Device
A device for electrically stimulating, and measuring electrical responses of, an internal organ of a patient while obtaining real time images of the internal organ, the device having an ultrasound probe; one or more electrodes connected to the ultrasound probe for electrically stimulating the organ and measuring responses from the organ, wherein the probe is placed at a location on the patient's body proximate the internal organ for obtaining the real time images of the organ; and a stimulator connected to the one or more electrodes for providing electric current of a predefined amplitude for stimulating the internal organ.
Methods and systems for conditioning a signal indicative of electrosurgical unit activity are described. A hardware circuit acquires AC current from an electrosurgical unit on patient isolated circuitry and conditions the signal in either of two alternate processing methods. The processed signal is routed as input to an analog to digital converter circuit. A method for determining saturation on referential inputs and recovering inputs to an unsaturated state is also described.
The present specification describes a system and method of detecting sleep disordered breathing, that includes acquiring a set of unconditioned sleep test data that includes oximetry data and at least one other physiological sensor data; sampling the set of unconditioned sleep test data; storing the sampled set of unconditioned sleep test data; receiving, through a display, an input indicative of a degree of analyzing to be applied to the sampled set of unconditioned sleep test data; based on said input, applying a corresponding degree of analyzing to the unprocessed sleep test data to generate processed sleep test data; and visually displaying the processed sleep test data.
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61B 5/1455 - Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value using optical sensors, e.g. spectral photometrical oximeters
21.
Systems and Methods for Processing and Displaying Electromyographic Signals
The present specification describes systems and methods that enable the automatic detection, analysis and calculation of various processes and parameters associated with electromyography. The methods of the present specification include the automated modulation of analytical or recording states based on the nature of the signal, optimal reference fiber selection, modulating a trigger level, and determining firing parameters.
A system for monitoring includes: multiple EEG sensors spatially positioned on a layer of tissue for capturing EEG signals of a patient; multiple amplifiers coupled with the EEG sensors for amplifying the captured signals; and a low frequency oscillator for generating a synchronizing signal which is distributed to the amplifiers for synchronizing the digitization of the captured signals; wherein each amplifier includes: a voltage controlled oscillator for an adjustable frequency reference; an analog to digital converter for converting the amplified signal to a digital value; and a microcontroller for controlling the frequency of the voltage controlled oscillator and operation of the analog to digital converter by using the synchronizing signal.
Computer-implemented methods of enabling an on-the-fly generation of at least one user-defined montage from EEG electrodes positioned in a patient's brain, on the patient's brain and/or on the patient's scalp. The methods includes generating a graphical interface to display a view of the patient's brain and/or scalp overlaid with the EEG electrodes, each of which is uniquely identified with reference to its position in the patient's brain, on the patient's brain and/or on the patient's scalp, displaying a tool within the graphical interface for selecting at least one electrode from the displayed EEG electrodes, indicating a reference electrode corresponding to the selected electrode, accessing EEG signals corresponding to the electrode and the reference electrode, and generating another graphical interface to display an EEG trace indicative of a comparison of EEG signals of the electrode and the reference electrode.
Systems and methods for ultrasound imaging include obtaining RF data using an ultrasound probe and processing the RF data in-parallel to generate B-mode data and echo intensity data during ultrasound examination of a patient. The RF data is analyzed in real-time to provide a user with live ultrasound image and echogenicity analytics. Based on the echogenicity analytics, the user may reposition the ultrasonic probe to adjust and select an optimal probe angle to ensure reproducible results. Providing live RF data allows the user to assess the health of nerves and muscles in real-time and make dynamic decisions on further exams to perform during the same office visit.
Methods of performing diagnostic tests on electroencephalography (EEG) recording devices comprising at least one stimulator coupled with a plurality of EEG electrode recording channels and corresponding recording channel connectors are performed by a test fixture comprising a plurality of resistors coupled with one or more of the EEG electrode recording channels and corresponding recording channel connectors. The methods include performing an impedance test for determining if each EEG recording channel of the EEG recording device has a predefined impedance, performing a channel uniqueness test for each EEG recording channel, performing a test for verifying the state of a switch of the stimulator of the EEG recording device, and performing a test for verifying connector IDs of the recording channel connectors connecting the EEG electrodes to respective EEG recording channels.
A respiratory monitoring system that uses an elastic cord with at least one wire wound around the elastic cord such that, when current passes through, it generates a magnetic field along the length of the elastic cord. The system further includes a recorder that measures changes in inductance and/or frequency in order to derive a respiratory rate of a patient in a coil cord. Embodiments of the system of the present specification have application in Respiratory Inductive Plethysmography (RIP) belts.
A training simulator for intraoperative neuromonitoring (IONM) systems includes channels where at least one of the channels is identified as an active stimulation channel and a subset of the rest of the channels is identified as reference or pick up sites. Channels of the subset having signal data that exceed a predefined threshold are retained for further processing, while channels with signal data that do not exceed the threshold are eliminated from further reporting. Response data for the remaining channels are generated in advance of a future time when the response would occur. The generated data is time stamped and stored for display at a time window when requested by the system.
An electrode configured for use in electromyography procedures including a shaft having a first end and a second end, where the shaft consists of a conductive material; an electrically insulative first coating configured to encase the conductive material; a tapered tip at the first end of the shaft, where the tip is angled and is formed by removing the first coating from a first portion of the shaft and exposing a first length of conductive material; and a hub positioned at the second end of the shaft, wherein the hub is positioned after removing the first coating from a second portion of the shaft and exposing a second length of conductive material, wherein the hub is configured to electrically couple a lead wire to the second length of conductive material at the second end.
An electrode management solution for neuromonitoring applications such as electroencephalography (EEG) procedures provides for the verification of the locations and connections of electrodes. The brain is modeled as a volume conductor and an expected attenuated signal generated by an electrical signal present in the form of an electrical dipole at any other point in the brain is calculated. A known signal is connected between electrodes at ‘presumed’ locations. This action generates a defined electrical field which can be measured between any of the other electrode locations. The amplitude and phase of the measured signals are a function of the input signal, the volume conductor, and the geometric relations of the two electrodes. By comparing the expected values with the measured values, the relation between the electrodes is verified.
The present specification discloses an intraoperative neurophysiological monitoring (IONM) system including a computing device capable of executing an IONM software engine, a stimulation module having multiple ports and various stimulation components and recording electrodes. The system is used to implement transcranial electrical stimulation and motor evoked potential monitoring by positioning at least one recording electrode on a patient, connecting the stimulation components to at least one port on the stimulation module, positioning the stimulation components on a patient's head, activating, using the IONM software engine, at least one port, delivering stimulation to the patient; and recording a stimulatory response on the patient.
Systems, devices and methods for advanced electrode management in neurological monitoring applications include receiving sockets configured to receive connectors having groups of electrodes. The physician is not required to manually map each electrode with its corresponding input channel. Electrodes are coupled to the corresponding input channels in groups through connectors having a unique identification (ID). The system is configured to read the unique ID of each connector and establish its identity. Based on the ID, the system configures itself to automatically correlate or associate each electrode with its corresponding input channel when the connectors are first inserted into the receiving sockets, and again if the connectors are removed and re-inserted into different positions in the receiving sockets, to insure the electrodes are always mapped to the same input channels.
A system for deploying an electrode array at a target location through a hole formed in the patient's cranium. The system includes an array of electrodes attached to a substrate and an inserter attached to the substrate and/or the array of electrodes. The inserter, substrate and array of electrodes are configured into a first compressed state and are positioned within the lumen of a cannula. Using the cannula, the system is inserted through the hole, the cannula is then removed, and the inserter is used to transition the substrate and electrode array from the first compressed state to a second uncompressed state, thereby deploying the array of electrodes at the target location.
A61N 1/372 - Arrangements in connection with the implantation of stimulators
A61B 1/313 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopesIlluminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
A61N 1/36 - Applying electric currents by contact electrodes alternating or intermittent currents for stimulation, e.g. heart pace-makers
33.
Connector receptacle with improved mating retention and release
A connector receptacle for connecting with a corresponding connector plug coupled with electrodes being used for performing EMG procedure on a patient is provided. The receptacle includes a first ball bearing pressing against a first end of a housing of the plug and, preferably, a second ball bearing pressing against a first end of the housing of the plug when the plug is connected to the receptacle for exerting a retention force against the plug. The first and the second ball bearings are pressed against the first and the second ends respectively by using a spring force generated, for example, by a retention band.
Systems, devices and methods are described for physiological monitoring, for example monitoring EEG signals to detect the onset or probability of adverse events. The systems, devices and methods discussed herein may monitor received EEG signals to identify trends or patterns in the signal that are either indicative of ongoing seizures or indicative of a future risk of seizure. The systems, devices and methods provide the user with increased control and flexibility in the monitoring processes that produce the alerts. In particular, in some implementations the physician is able to make adjustments during monitoring and customize the process by which EEG data is displayed and analyzed during the patient monitoring without pausing the monitoring to make the adjustments.
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
G16H 50/30 - ICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indicesICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for individual health risk assessment
A61B 5/316 - Modalities, i.e. specific diagnostic methods
Systems, devices and methods are provided for neuromonitoring, particularly neuromonitoring to reduce the risks of contacting or damaging nerves or causing patient discomfort during and after surgical procedures, including spinal surgeries. The neuromonitoring procedures include monitoring for the presence of or damage to sensory nerves, and optionally includes additional monitoring for motor nerves. In some systems, including systems that monitor for both sensory and motor nerves, components of the monitoring systems (e.g., stimulating electrodes and response sensors), may be combined with one or more surgical instruments. The systems, devices, and methods provide for pre-surgical assessment of neural anatomy and surgical planning, intraoperative monitoring of nerve condition, and post-operative assessment of nerve position and health.
Systems, devices and methods are described for mounting medical equipment on IV poles, bed rails and other supporting structures in medical facilities including operating rooms and critical care sections. A system including a mounting hanger and corresponding equipment housing is disclosed that allows quick mounting and dismounting of equipment from a supporting structure. The novel structural design of mounting hanger including a symmetrical t-slot feature and a plunger lock allows a piece of equipment to be mounted on a supporting structure in multiple orientations as per the requirement which allows a user to optimize the placement of equipment in the medical environment.
F16M 11/08 - Means for attachment of apparatusMeans allowing adjustment of the apparatus relatively to the stand allowing pivoting around a vertical axis
F16M 13/02 - Other supports for positioning apparatus or articlesMeans for steadying hand-held apparatus or articles for supporting on, or attaching to, an object, e.g. tree, gate, window-frame, cycle
A61B 90/50 - Supports for surgical instruments, e.g. articulated arms
Systems, devices, and methods are described for neuromonitoring. A minimum stimulus signal required to elicit a threshold neuromuscular response is determined by delivery of stimulus signals to tissue and detection of neuromuscular responses in muscle tissue. The strength of the delivered stimulus signals is varied, for example by adjusting the current amplitude or pulse width of the signals, and muscle responses are measure, for example by detecting EMG signals. The delivered stimuli and corresponding responses are then used to determine a stimulation threshold. The stimulation threshold may be used to indicate at least one of nerve proximity and pedicle integrity.
Methods and systems for conditioning a signal indicative of electrosurgical unit activity are described. A hardware circuit acquires AC current from an electrosurgical unit on patient isolated circuitry and conditions the signal in either of two alternate processing methods. The processed signal is routed as input to an analog to digital converter circuit. A method for determining saturation on referential inputs and recovering inputs to an unsaturated state is also described.
A connector receptacle for connecting with a corresponding connector plug coupled with electrodes being used for performing EMG procedure on a patient is provided. The receptacle includes a first ball bearing pressing against a first end of a housing of the plug and, preferably, a second ball bearing pressing against a first end of the housing of the plug when the plug is connected to the receptacle for exerting a retention force against the plug. The first and the second ball bearings are pressed against the first and the second ends respectively by using a spring force generated, for example, by a retention band.
Systems, devices and methods for advanced electrode management in neurological monitoring applications include receiving sockets configured to receive connectors having groups of electrodes. The physician is not required to manually map each electrode with its corresponding input channel. Electrodes are coupled to the corresponding input channels in groups through connectors having a unique identification (ID). The system is configured to read the unique ID of each connector and establish its identity. Based on the ID, the system configures itself to automatically correlate or associate each electrode with its corresponding input channel when the connectors are first inserted into the receiving sockets, and again if the connectors are removed and re-inserted into different positions in the receiving sockets, to insure the electrodes are always mapped to the same input channels.
Computer-implemented methods of enabling an on-the-fly generation of at least one user-defined montage from EEG electrodes positioned in a patient's brain, on the patient's brain and/or on the patient's scalp. The methods includes generating a graphical interface to display a view of the patient's brain and/or scalp overlaid with the EEG electrodes, each of which is uniquely identified with reference to its position in the patient's brain, on the patient's brain and/or on the patient's scalp, displaying a tool within the graphical interface for selecting at least one electrode from the displayed EEG electrodes, indicating a reference electrode corresponding to the selected electrode, accessing EEG signals corresponding to the electrode and the reference electrode, and generating another graphical interface to display an EEG trace indicative of a comparison of EEG signals of the electrode and the reference electrode.
A training simulator for intraoperative neuromonitoring (IONM) systems includes channels where at least one of the channels is identified as an active stimulation channel and a subset of the rest of the channels is identified as reference or pick up sites. Channels of the subset having signal data that exceed a predefined threshold are retained for further processing, while channels with signal data that do not exceed the threshold are eliminated from further reporting. Response data for the remaining channels are generated in advance of a future time when the response would occur. The generated data is time stamped and stored for display at a time window when requested by the system.
Systems, devices and methods are described for connecting multiple electrical connectors as a group with corresponding receiving sockets, or connection ports, in a medical device. A multiple electrical connector plate acts as an intermediate connector for quickly engaging or disengaging a group of electrodes with the corresponding device as a single unit. The connection plate includes multiple sections that allow a connector to be snapped securely in place on the connection plate such that the connector does not pull or push free from its snapped in location, resulting in group handling of electrical connectors that is less time consuming, reduces errors and positively impacts the quality of medical care.
H01R 13/62 - Means for facilitating engagement or disengagement of coupling parts or for holding them in engagement
H01R 25/16 - Rails or bus-bars provided with a plurality of discrete connecting locations for counterparts
H01R 13/518 - Means for holding or embracing insulating body, e.g. casing for holding or embracing several coupling parts, e.g. frames
H01R 43/26 - Apparatus or processes specially adapted for manufacturing, assembling, maintaining, or repairing of line connectors or current collectors or for joining electric conductors for engaging or disengaging the two parts of a coupling device
An integrated switch matrix for a medical device system used for long-term monitoring of electroencephalogram (EEG) signals and mapping of the brain through cortical stimulation is configured to switch functions of various electrodes associated with the system in response to user needs. The programmable switch matrix is integrated in an EEG recording device and allows for connecting any patient electrode(s) to a ground circuit, connecting any patient electrode to a common reference, connecting a selected common reference to any or all recording device(s) in the system and, connecting any patient electrode(s) to anode and/or cathode outputs of a neurostimulator for multi-contact cortical stimulation.
Methods of performing diagnostic tests on electroencephalography (EEG) recording devices comprising at least one stimulator coupled with a plurality of EEG electrode recording channels and corresponding recording channel connectors are performed by a test fixture comprising a plurality of resistors coupled with one or more of the EEG electrode recording channels and corresponding recording channel connectors. The methods include performing an impedance test for determining if each EEG recording channel of the EEG recording device has a predefined impedance, performing a channel uniqueness test for each EEG recording channel, performing a test for verifying the state of a switch of the stimulator of the EEG recording device, and performing a test for verifying connector IDs of the recording channel connectors connecting the EEG electrodes to respective EEG recording channels.
An electrode management solution for neuromonitoring applications such as electroencephalography (EEG) procedures provides for the verification of the locations and connections of electrodes. The brain is modeled as a volume conductor and an expected attenuated signal generated by an electrical signal present in the form of an electrical dipole at any other point in the brain is calculated. A known signal is connected between electrodes at ‘presumed’ locations. This action generates a defined electrical field which can be measured between any of the other electrode locations. The amplitude and phase of the measured signals are a function of the input signal, the volume conductor, and the geometric relations of the two electrodes. By comparing the expected values with the measured values, the relation between the electrodes is verified.
A system for monitoring includes: multiple EEG sensors spatially positioned on a layer of tissue for capturing EEG signals of a patient; multiple amplifiers coupled with the EEG sensors for amplifying the captured signals; and a low frequency oscillator for generating a synchronizing signal which is distributed to the amplifiers for synchronizing the digitization of the captured signals; wherein each amplifier includes: a voltage controlled oscillator for an adjustable frequency reference; an analog to digital converter for converting the amplified signal to a digital value; and a microcontroller for controlling the frequency of the voltage controlled oscillator and operation of the analog to digital converter by using the synchronizing signal.
A system for deploying an electrode array at a target location through a hole formed in the patient's cranium. The system includes an array of electrodes attached to a substrate and an inserter attached to the substrate and/or the array of electrodes. The inserter, substrate and array of electrodes are configured into a first compressed state and are positioned within the lumen of a cannula. Using the cannula, the system is inserted through the hole, the cannula is then removed, and the inserter is used to transition the substrate and electrode array from the first compressed state to a second uncompressed state, thereby deploying the array of electrodes at the target location.
Systems, devices and methods for advanced electrode management in neurological monitoring applications include receiving sockets configured to receive connectors having groups of electrodes. The physician is not required to manually map each electrode with its corresponding input channel. Electrodes are coupled to the corresponding input channels in groups through connectors having a unique identification (ID). The system is configured to read the unique ID of each connector and establish its identity. Based on the ID, the system configures itself to automatically correlate or associate each electrode with its corresponding input channel when the connectors are first inserted into the receiving sockets, and again if the connectors are removed and re-inserted into different positions in the receiving sockets, to insure the electrodes are always mapped to the same input channels.
Systems, devices and methods are described for mounting medical equipment on IV poles, bed rails and other supporting structures in medical facilities including operating rooms and critical care sections. A system including a mounting hanger and corresponding equipment housing is disclosed that allows quick mounting and dismounting of equipment from a supporting structure. The novel structural design of mounting hanger including a symmetrical t-slot feature and a plunger lock allows a piece of equipment to be mounted on a supporting structure in multiple orientations as per the requirement which allows a user to optimize the placement of equipment in the medical environment.
F16M 11/08 - Means for attachment of apparatusMeans allowing adjustment of the apparatus relatively to the stand allowing pivoting around a vertical axis
F16M 13/02 - Other supports for positioning apparatus or articlesMeans for steadying hand-held apparatus or articles for supporting on, or attaching to, an object, e.g. tree, gate, window-frame, cycle
A61B 90/50 - Supports for surgical instruments, e.g. articulated arms
51.
Methods and Systems for Simultaneous Review of Brain Activity and Physical Manifestations of Users
Methods and systems are disclosed for a guidance application that allows a practitioner to easily correlate a fluctuation in any channel of a plurality of channels constituting received electroencephalography (“EEG”) data to a particular physical manifestation. For example, the guidance application automatically synchronizes incoming EEG data to the physical manifestations and allows for automatic retrieval a portion of video data (e.g., of the physical manifestation) that corresponds to a selected portion of EEG data.
Systems, devices and methods for advanced electrode management in neurological monitoring applications include receiving sockets configured to receive connectors having groups of electrodes. The physician is not required to manually map each electrode with its corresponding input channel. Electrodes are coupled to the corresponding input channels in groups through connectors having a unique identification (ID). The system is configured to read the unique ID of each connector and establish its identity. Based on the ID, the system configures itself to automatically correlate or associate each electrode with its corresponding input channel when the connectors are first inserted into the receiving sockets, and again if the connectors are removed and re-inserted into different positions in the receiving sockets, to insure the electrodes are always mapped to the same input channels.
The present specification discloses an intraoperative neurophysiological monitoring (IONM) system including a computing device capable of executing an IONM software engine, a stimulation module having multiple ports and various stimulation components and recording electrodes. The system is used to implement transcranial electrical stimulation and motor evoked potential monitoring by positioning at least one recording electrode on a patient, connecting the stimulation components to at least one port on the stimulation module, positioning the stimulation components on a patient's head, activating, using the IONM software engine, at least one port, delivering stimulation to the patient; and recording a stimulatory response on the patient.
An intraoperative neurophysiological monitoring (IONM) system for identifying and assessing neural structures comprises at least one probe, at least one reference electrode, at least one strip or grid electrode, at least one sensing electrode, and a stimulation module. Threshold responses determined by stimulation during a surgical procedure are used to identify and assess functionality of neural structures. The identified neural structures are avoided and preserved while diseased or damaged tissue is resected during said surgical procedure.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
55.
Systems and methods for processing and displaying electromyographic signals
The present specification describes systems and methods that enable the automatic detection, analysis and calculation of various processes and parameters associated with electromyography. The methods of the present specification include the automated modulation of analytical or recording states based on the nature of the signal, optimal reference fiber selection, modulating a trigger level, and determining firing parameters.
Methods and systems are disclosed for a guidance application that allows a practitioner to easily correlate a fluctuation in any channel of a plurality of channels constituting received electroencephalography (“EEG”) data to a particular physical manifestation. For example, the guidance application automatically synchronizes incoming EEG data to the physical manifestations and allows for automatic retrieval a portion of video data (e.g., of the physical manifestation) that corresponds to a selected portion of EEG data.
Systems, devices, and methods are described for neuromonitoring. A minimum stimulus signal required to elicit a threshold neuromuscular response is determined by delivery of stimulus signals to tissue and detection of neuromuscular responses in muscle tissue. The strength of the delivered stimulus signals is varied, for example by adjusting the current amplitude or pulse width of the signals, and muscle responses are measure, for example by detecting EMG signals. The delivered stimuli and corresponding responses are then used to determine a stimulation threshold. The stimulation threshold may be used to indicate at least one of nerve proximity and pedicle integrity.
Systems, devices and methods are provided for neuromonitoring, particularly neuromonitoring to reduce the risks of contacting or damaging nerves or causing patient discomfort during and after surgical procedures, including spinal surgeries. The neuromonitoring procedures include monitoring for the presence of or damage to sensory nerves, and optionally includes additional monitoring for motor nerves. In some systems, including systems that monitor for both sensory and motor nerves, components of the monitoring systems (e.g., stimulating electrodes and response sensors), may be combined with one or more surgical instruments. The systems, devices, and methods provide for pre-surgical assessment of neural anatomy and surgical planning, intraoperative monitoring of nerve condition, and post-operative assessment of nerve position and health.
Systems, devices and methods are described for connecting multiple electrical connectors as a group with corresponding receiving sockets, or connection ports, in a medical device. A multiple electrical connector plate acts as an intermediate connector for quickly engaging or disengaging a group of electrodes with the corresponding device as a single unit. The connection plate includes multiple sections that allow a connector to be snapped securely in place on the connection plate such that the connector does not pull or push free from its snapped in location, resulting in group handling of electrical connectors that is less time consuming, reduces errors and positively impacts the quality of medical care.
H01R 13/62 - Means for facilitating engagement or disengagement of coupling parts or for holding them in engagement
H01R 25/16 - Rails or bus-bars provided with a plurality of discrete connecting locations for counterparts
H01R 43/26 - Apparatus or processes specially adapted for manufacturing, assembling, maintaining, or repairing of line connectors or current collectors or for joining electric conductors for engaging or disengaging the two parts of a coupling device
H01R 13/518 - Means for holding or embracing insulating body, e.g. casing for holding or embracing several coupling parts, e.g. frames
Systems, devices and methods are described for mounting medical equipment on IV poles, bed rails and other supporting structures in medical facilities including operating rooms and critical care sections. A system including a mounting hanger and corresponding equipment housing is disclosed that allows quick mounting and dismounting of equipment from a supporting structure. The novel structural design of mounting hanger including a symmetrical t-slot feature and a plunger lock allows a piece of equipment to be mounted on a supporting structure in multiple orientations as per the requirement which allows a user to optimize the placement of equipment in the medical environment.
F16M 11/08 - Means for attachment of apparatusMeans allowing adjustment of the apparatus relatively to the stand allowing pivoting around a vertical axis
A61B 90/50 - Supports for surgical instruments, e.g. articulated arms
F16M 13/02 - Other supports for positioning apparatus or articlesMeans for steadying hand-held apparatus or articles for supporting on, or attaching to, an object, e.g. tree, gate, window-frame, cycle
61.
SYSTEM AND METHOD FOR HIGH DENSITY ELECTRODE MANAGEMENT
Systems, devices and methods for advanced electrode management in neurological monitoring applications include receiving sockets configured to receive connectors having groups of electrodes. The physician is not required to manually map each electrode with its corresponding input channel. Electrodes are coupled to the corresponding input channels in groups through connectors having a unique identification (ID). The system is configured to read the unique ID of each connector and establish its identity. Based on the ID, the system configures itself to automatically correlate or associate each electrode with its corresponding input channel when the connectors are first inserted into the receiving sockets, and again if the connectors are removed and re-inserted into different positions in the receiving sockets, to insure the electrodes are always mapped to the same input channels.
Systems, devices and methods for advanced electrode management in neurological monitoring applications include receiving sockets configured to receive connectors having groups of electrodes. The physician is not required to manually map each electrode with its corresponding input channel. Electrodes are coupled to the corresponding input channels in groups through connectors having a unique identification (ID). The system is configured to read the unique ID of each connector and establish its identity. Based on the ID, the system configures itself to automatically correlate or associate each electrode with its corresponding input channel when the connectors are first inserted into the receiving sockets, and again if the connectors are removed and re-inserted into different positions in the receiving sockets, to insure the electrodes are always mapped to the same input channels.
An apparatus, system, and method are disclosed for mapping the location of a nerve. The apparatus includes at least one stimulation module, a stimulation detection module, a distance module, and a mapping module. The stimulation module stimulates a nerve with an electrical stimulation current from at least one stimulation electrode. A stimulation detection module detects a muscle reaction resulting from stimulation of the nerve by the at least one stimulation electrode. The distance module uses information from the at least one stimulation electrode and from the stimulation detection module to calculate a distance between the at least one stimulation electrode and the nerve. The mapping module maps a location on the nerve using at least two distances calculated by the distance module and position information of the at least one stimulation electrode for each of the at least two distances calculated.
A61B 5/0492 - Electrodes specially adapted therefor, e.g. needle electrodes
A61B 5/055 - Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fieldsMeasuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
A61B 6/00 - Apparatus or devices for radiation diagnosisApparatus or devices for radiation diagnosis combined with radiation therapy equipment
Systems, devices and methods are described for connecting multiple electrical connectors as a group with corresponding receiving sockets, or connection ports, in a medical device. A multiple electrical connector plate acts as an intermediate connector for quickly engaging or disengaging a group of electrodes with the corresponding device as a single unit. The connection plate includes multiple sections that allow a connector to be snapped securely in place on the connection plate such that the connector does not pull or push free from its snapped in location, resulting in group handling of electrical connectors that is less time consuming, reduces errors and positively impacts the quality of medical care.
H01R 4/2429 - Flat plates, e.g. multi-layered flat plates mounted in an insulating base
H01R 13/62 - Means for facilitating engagement or disengagement of coupling parts or for holding them in engagement
H01R 25/16 - Rails or bus-bars provided with a plurality of discrete connecting locations for counterparts
H01R 43/26 - Apparatus or processes specially adapted for manufacturing, assembling, maintaining, or repairing of line connectors or current collectors or for joining electric conductors for engaging or disengaging the two parts of a coupling device
Systems, devices, and methods are described for neuromonitoring. A minimum stimulus signal required to elicit a threshold neuromuscular response is determined by delivery of stimulus signals to tissue and detection of neuromuscular responses in muscle tissue. The strength of the delivered stimulus signals is varied, for example by adjusting the current amplitude or pulse width of the signals, and muscle responses are measure, for example by detecting EMG signals. The delivered stimuli and corresponding responses are then used to determine a stimulation threshold. The stimulation threshold may be used to indicate at least one of nerve proximity and pedicle integrity.
Systems, devices and methods are provided for neuromonitoring, particularly neuromonitoring to reduce the risks of contacting or damaging nerves or causing patient discomfort during and after surgical procedures, including spinal surgeries. The neuromonitoring procedures include monitoring for the presence of or damage to sensory nerves, and optionally includes additional monitoring for motor nerves. In some systems, including systems that monitor for both sensory and motor nerves, components of the monitoring systems (e.g., stimulating electrodes and response sensors), may be combined with one or more surgical instruments. The systems, devices, and methods provide for pre-surgical assessment of neural anatomy and surgical planning, intraoperative monitoring of nerve condition, and post-operative assessment of nerve position and health.
Systems, devices, and methods are described for neuromonitoring. A minimum stimulus signal required to elicit a threshold neuromuscular response is determined by delivery of stimulus signals to tissue and detection of neuromuscular responses in muscle tissue. The strength of the delivered stimulus signals is varied, for example by adjusting the current amplitude or pulse width of the signals, and muscle responses are measure, for example by detecting EMG signals. The delivered stimuli and corresponding responses are then used to determine a stimulation threshold. The stimulation threshold may be used to indicate at least one of nerve proximity and pedicle integrity.
A locking mechanism for electrical connectors is disclosed. The locking mechanism comprises one or more sockets affixed to one of a pair of electrical connectors, e.g., a male electrical connector, and one or more mating studs affixed to the other of the pair of electrical connectors, e.g., a female electrical connector. The sockets lockingly engage the studs when the pair of electrical connectors are connected. The sockets are affixed to the male electrical by ribs, which form part of elongate socket fittings that also include the sockets, and socket fitting retainers. The studs are affixed to the female electrical connector by threads.
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