Systems and methods for performaing neurophysiologic monitoring

Abstract

The present invention relates to a system and methods generally aimed at surgery. More particularly, the present invention is directed at a system and related methods for performing surgical procedures and assessments involving the use of neurophysiology.

1 - 20 . (canceled) 
     
     
         21 . A method comprising:
 operating a neuromonitoring system in a somatosensory evoked potential (SSEP) mode;   while operating the neuromonitoring system in the SSEP mode:
 providing a user interface showing an anatomical diagram of a body; 
 determining a SSEP baseline; 
 performing SSEP stimulation at a plurality of different SSEP stimulation sites; 
 performing SSEP recording at only two SSEP recording sites of a plurality of recording sites; and 
 coloring a representation of a limb on the anatomical diagram of the body according to a comparison of one or more attributes of an SSEP recording relative to one or more attributes of the SSEP baseline. 
   
     
     
         22 . The method of  claim 21 , wherein the one or more attributes include amplitude and latency. 
     
     
         23 . The method of  claim 21 , further comprising:
 comparing a first amplitude of the SSEP recording relative to a baseline amplitude of the SSEP baseline;   comparing a first latency of the SSEP recording relative to a baseline latency of the SSEP baseline; and   coloring a representation of a limb on the anatomical diagram of the body green responsive to determining that both:
 the first amplitude has a less than 50% change in amplitude relative to the baseline amplitude; and 
 the first latency has a less than 10% increase relative to the baseline latency. 
   
     
     
         24 . The method of  claim 23 , further comprising:
 comparing a second amplitude of the SSEP recording to a baseline amplitude of the SSEP baseline;   comparing a second latency of the SSEP recording relative to a baseline latency of the SSEP baseline; and   coloring the representation of the limb on the anatomical diagram of the body yellow responsive to determining that either:
 the second amplitude has a more than 50% change in amplitude relative to the baseline amplitude; or 
 the second latency has a greater than 10% increase relative to the baseline latency. 
   
     
     
         25 . The method of  claim 21 , further comprising:
 wherein the plurality of different SSEP stimulation sites include only four SSEP stimulation sites.   
     
     
         26 . The method of  claim 21 ,
 wherein the only two SSEP recording sites include a first recording location referenced to another recording location.   
     
     
         27 . The method of  claim 21 , wherein the plurality of different SSEP stimulation sites include:
 a left posterior tibial nerve SSEP stimulation site;   a right posterior tibial nerve SSEP stimulation site;   a left ulnar nerve SSEP stimulation site; and   a right ulnar nerve SSEP stimulation site.   
     
     
         28 . The method of  claim 21 , wherein an electrode provides a ground reference. 
     
     
         29 . The method of  claim 21 ,
 wherein the neuromonitoring system includes a patient module, a controller, and a plurality of electrodes; and   wherein the method further comprises:
 communicatively coupling the patient module with the controller; 
 placing each of the plurality of electrodes at either (i) each one of the plurality of different SSEP stimulation sites, or (ii) each one of the two SSEP recording sites; and 
 coupling the plurality of electrodes to the patient module. 
   
     
     
         30 . The method of  claim 29 , further comprising:
 coupling a test probe to the patient module or coupling a surgical tool clip to the patient module.   
     
     
         31 . The method of  claim 29 , further comprising:
 mounting the patient module to a rail.   
     
     
         32 . The method of  claim 29 ,
 wherein the communicatively coupling includes communicatively coupling the patient module with the controller using a USB cable; or   wherein the communicatively coupling includes wirelessly communicatively coupling the patient module with the controller;   
     
     
         33 . The method of  claim 21 ,
 wherein providing the user interface showing the anatomical diagram of the body includes:   showing an electromyography (EMG) user interface element on the user interface; and   wherein the method further includes:
 responsive to detecting actuation of the EMG user interface element, operating the neuromonitoring system in an EMG mode. 
   
     
     
         34 . A system comprising:
 patient module;   a controller comprising a display; and   a plurality of electrodes,
 wherein the controller is configured to: 
 provide, at the display, an SSEP user interface showing an anatomical diagram of a body; 
 determine an SSEP baseline; 
 cause the patient module to perform SSEP stimulation at one or more of a plurality of different SSEP stimulation sites using one or more stimulating electrodes of the plurality of electrodes; 
 cause the patient module to perform SSEP recording at only two SSEP recording sites using two recording electrodes of the plurality of electrodes; and 
 at the SSEP user interface, color a representation of a limb on the anatomical diagram of the body according to a comparison of one or more attributes of the SSEP recording relative to one or more attributes of the SSEP baseline. 
   
     
     
         35 . The system of  claim 34 , wherein the controller is further configured to:
 color a representation of a limb on the anatomical diagram of the body green responsive to determining that both:
 an SSEP amplitude of the SSEP recording has a less than 50% change in amplitude relative to a baseline SSEP amplitude of the SSEP baseline; and 
 an SSEP latency of the SSEP recording has a less than 10% increase in latency relative to a baseline SSEP latency of the SSEP baseline. 
   
     
     
         36 . The system of  claim 34 , wherein the controller is further configured to:
 color a representation of a limb on the anatomical diagram of the body yellow responsive to determining that either:
 an SSEP amplitude of the SSEP recording has a more than 50% change in amplitude relative to the baseline amplitude of the SSEP baseline; or 
 an SSEP latency of the SSEP recording has a greater than 10% increase in latency relative to a baseline SSEP latency of the SSEP baseline. 
   
     
     
         37 . The system of  claim 34 , further comprising:
 a USB cable coupling the patient module and the controller.   
     
     
         38 . The system of  claim 34 , further comprising:
 a test probe or a surgical tool clip.   
     
     
         39 . The system of  claim 34 ,
 wherein to provide the SSEP user interface showing the anatomical diagram of the body includes to:
 show an electromyography (EMG) user interface element on the SSEP user interface; and 
   wherein the controller is further configured to:
 responsive to detecting actuation of the EMG user interface element, operate the neuromonitoring system in an EMG mode. 
   
     
     
         40 . The system of  claim 34 ,
 wherein the patient module comprises:
 a controller port configured for coupling the patient module with the controller; 
 one or more electrical connectors for electrically coupling the patient module with the plurality of electrodes; 
 SSEP stimulating circuitry for delivering SSEP stimulation with the one or more stimulating electrodes; and 
 SSEP recording circuitry for recording with the two recording electrodes.