US 11,992,339 B2
Systems and methods for dynamic neurophysiological stimulation
Melissa Kirkup, West Linn, OR (US); Richard A. Villarreal, West Richland, WA (US); and John A. Cadwell, Jr., Richland, WA (US)
Filed by Cadwell Laboratories, Inc., Kennewick, WA (US)
Filed on May 3, 2019, as Appl. No. 16/402,544.
Claims priority of provisional application 62/666,959, filed on May 4, 2018.
Prior Publication US 2019/0336073 A1, Nov. 7, 2019
Int. Cl. A61B 5/00 (2006.01); A61B 5/24 (2021.01); A61B 5/296 (2021.01); A61B 5/389 (2021.01); A61B 18/12 (2006.01)
CPC A61B 5/4893 (2013.01) [A61B 5/24 (2021.01); A61B 5/296 (2021.01); A61B 5/389 (2021.01); A61B 5/4064 (2013.01); A61B 2018/1253 (2013.01); A61B 2018/126 (2013.01)] 23 Claims
OG exemplary drawing
 
1. A method of using cortical stimulation to assess neural structures during a surgical procedure, the method comprising:
providing an intraoperative neurophysiological monitoring (IONM) system comprising at least one probe, at least one reference electrode, at least one strip electrode or grid electrode, at least one sensing electrode, a stimulation module and a handle having a proximal end configured to connect to the stimulation module and a distal end configured to attach to the at least one probe, wherein the handle comprises a first visual indicator, a second visual indicator, and an actuator configured to automatically switch the stimulation module between a first mode of operation and a second mode of operation depending upon a type of the at least one probe, and wherein the first mode of operation is a bipolar mode and the second mode of operation is a monopolar mode;
placing the at least one reference electrode in a perimeter of a surgical field of a patient;
positioning the at least one probe and/or the at least one strip electrode or grid electrode at target locations on the anatomy of said patient;
preparing for recordation of said patient's responses to stimulation by positioning said at least one sensing electrode on said patient's anatomy;
initiating a stimulation protocol in accordance with the automatically selected first mode of operation or second mode of operation;
adjusting stimulation parameters of the stimulation protocol to determine a threshold response; and
assessing the neural structures based on said threshold response, wherein assessing comprises determining whether the patient's anatomy is functioning in a manner indicative of an underlying disease.