US 12,343,069 B2
EMG guidance for probe placement, nearby tissue preservation, and lesion confirmation
Eric A. Schepis, Alpharetta, GA (US); Sara Kebede, New Orleans, LA (US); Phillip A. Schorr, Cumming, GA (US); David T. Curd, Alpharetta, GA (US); and Craig F. Steinman, Cumming, GA (US)
Assigned to Avent, Inc., Alpharetta, GA (US)
Appl. No. 16/482,452
Filed by Avent, Inc., Alpharetta, GA (US)
PCT Filed Jan. 25, 2018, PCT No. PCT/US2018/015127
§ 371(c)(1), (2) Date Jul. 31, 2019,
PCT Pub. No. WO2018/144297, PCT Pub. Date Aug. 9, 2018.
Claims priority of provisional application 62/453,232, filed on Feb. 1, 2017.
Prior Publication US 2020/0038096 A1, Feb. 6, 2020
Int. Cl. A61B 18/14 (2006.01); A61B 5/00 (2006.01); A61B 5/296 (2021.01); A61B 18/00 (2006.01); A61N 1/05 (2006.01)
CPC A61B 18/148 (2013.01) [A61B 5/296 (2021.01); A61B 5/6848 (2013.01); A61N 1/0551 (2013.01); A61B 2018/00577 (2013.01); A61B 2018/00839 (2013.01)] 33 Claims
OG exemplary drawing
 
1. A system for locating a first target nerve associated with a facet joint via nerve stimulation and monitoring of electrical muscle activity in a multifidus muscle adjacent the first target nerve, the multifidus muscle comprising a medial fascicle, an intermediate fascicle, and a lateral fascicle, wherein the system comprises:
a first probe comprising an insulated shaft and a first probe electrode located at a distal end of the insulated shaft, wherein the first probe electrode includes an array of independent channels for nerve stimulation, nerve ablation, or a combination thereof, and wherein the first probe is configured to form a lesion on the first target nerve by delivery of radiofrequency ablation energy;
a first recording electrode for monitoring electrical muscle activity in the medial fascicle of the multifidus muscle, wherein the first recording electrode is configured for placement in the medial fascicle of the multifidus muscle;
a signal generator; and
a controller coupled to the first probe electrode and the first recording electrode, wherein the controller delivers a first nerve stimulation from the signal generator to the first target nerve via the first probe electrode, wherein the controller monitors electrical muscle activity in the medial fascicle via the first recording electrode, wherein proximity of the first probe to the first target nerve is determined by the electrical muscle activity, electromyography (EMG) burst area, and amplitude in the medial fascicle elicited as a result of the first nerve stimulation, wherein the controller provides feedback to a user to guide placement of the first probe adjacent the first target nerve, and wherein the controller is configured to selectively activate one or more of the array of independent channels,
wherein the controller is configured to: (i) confirm that the first target nerve is a source of pain based, at least in part, on a detected latency between application of the first nerve stimulation and at least one EMG burst in the electrical muscle activity, and (ii) confirm successful formation of the lesion via the first recording electrode based on a difference in electrical muscle activity, EMG burst area, and amplitude elicited by a post-ablation nerve stimulation.