Abstract: A method for intraoperative guidance during a surgical procedure involving a nerve includes receiving real-time image data from an intraoperative imaging modality, the real-time image data depicting anatomical structures within an intracorporeal treatment area including the nerve; determining at least one nerve function parameter indicative of nerve health; and controlling a display device to concurrently present a visual output comprising both a visual representation derived from the real-time image data and a visual indication of the determined at least one nerve function parameter. The concurrently presented visual output facilitates assessment of the nerve relative to the anatomical structures during the surgical procedure.

Abstract: A system for assessing nerve health during spinal decompression surgery includes a stimulator, a mechanomyography sensor including an accelerometer, a display device, and a processor. The processor controls the stimulator to deliver a first electrical stimulus to a nerve prior to surgical decompression and a second electrical stimulus after surgical decompression. The processor determines a first stimulation threshold from responses detected by the sensor before decompression and a second stimulation threshold from responses detected after decompression. The processor accesses a target threshold range indicative of adequate decompression. The processor then calculates a first deviation of the first stimulation threshold from the target threshold range and a second deviation of the second stimulation threshold from the target threshold range. A value representing a change in nerve function is computed, wherein the value is based on a comparison of the first deviation to the second deviation.

Abstract: A method for intraoperative guidance during a surgical procedure involving a nerve includes receiving real-time image data from an intraoperative imaging modality, the real-time image data depicting anatomical structures within an intracorporeal treatment area including the nerve; determining at least one nerve function parameter indicative of nerve health; and controlling a display device to concurrently present a visual output comprising both a visual representation derived from the real-time image data and a visual indication of the determined at least one nerve function parameter. The concurrently presented visual output facilitates assessment of the nerve relative to the anatomical structures during the surgical procedure.

Abstract: A method for generating a predictive model for clinical outcomes of spinal decompression surgery includes accessing a database containing historical data from a plurality of patients, where the historical data includes, for each patient: (i) patient-specific attributes, (ii) post-decompression nerve function parameters, and (iii) clinical outcomes. The processor establishes a baseline target threshold range indicative of adequate nerve decompression, the range comprising electrical current values between approximately 2 mA and approximately 3 mA. The processor determines, for each patient, a nerve function metric by comparing post-decompression nerve function parameters to the baseline target threshold range. The processor categorizes the plurality of patients into a plurality of outcome-based groups by correlating the determined nerve function metrics with the clinical outcomes.

Abstract: A method for intraoperative guidance during a surgical procedure involving a nerve includes receiving real-time image data from an intraoperative imaging modality, the real-time image data depicting anatomical structures within an intracorporeal treatment area including the nerve; determining at least one nerve function parameter indicative of nerve health; and controlling a display device to concurrently present a visual output comprising both a visual representation derived from the real-time image data and a visual indication of the determined at least one nerve function parameter. The concurrently presented visual output facilitates assessment of the nerve relative to the anatomical structures during the surgical procedure.

Abstract: A system for longitudinal assessment of nerve health includes a stimulator to deliver electrical stimuli proximate a target nerve, a sensor to detect muscle responses evoked by the stimuli, a display, and a processor in communication with the stimulator, sensor, and display. The processor controls delivery of the stimuli; determines, from the detected muscle response, one or more nerve-function parameters for the target nerve including at least a stimulation threshold; stores the parameters with a session identifier; retrieves parameters from multiple sessions to compute a longitudinal trend; and controls the display to present the trend together with an indication of the target nerve's status relative to a target range. The system supports objective session-to-session tracking to inform clinical decisions.

Abstract: A method for assessing nerve health during a surgical procedure includes: applying one or more electrical stimuli proximate to the target nerve during the surgical procedure; detecting a muscle response evoked by the one or more electrical stimuli; determining at least one nerve function parameter indicative of the health or function of the target nerve; identifying a target range for the at least one nerve function parameter adapted for the target nerve, the target range being predictive of a desired nerve health status of the target nerve; and outputting an indication of the determined at least one nerve function parameter relative to the identified target range to provide real-time feedback during the surgical procedure involving the target nerve.

Abstract: A method for refining a nerve health assessment model used during surgical procedures, includes accessing a database storing historical patient data; analyzing the historical patient data to generate or update a predictive model configured to estimate at least one of: a predicted post-operative outcome, an individualized target range for an intraoperative nerve function parameter, or a statistical risk profile for surgical complications; obtaining current intraoperative nerve function measurements; receiving actual post-operative outcome data for the current patient; updating the database to include new patient data associated with the current patient; and refining the predictive model based at least in part on the new patient data added to the database.

Abstract: A method for intraoperative neural monitoring during a spinal decompression procedure, performed by a system comprising a processor, includes: generating an electrical stimulus with a controlled electrical current; transmitting the stimulus to an electrode contacting a nerve of a subject; receiving a mechanomyography (MMG) output signal from a mechanical sensor contacting a muscle innervated by the nerve; determining a nerve function parameter; and displaying the determined nerve function parameter relative to an identified target current range or statistical profile.

Abstract: A method for assessing nerve health during a spinal decompression procedure includes: accessing a database containing historical patient data; receiving patient data of a target patient; identifying a subset of historical patients with similar pre-operative characteristics; generating an individualized target range for at least one nerve function parameter based on the subset; measuring an actual nerve function parameter of the target patient during the procedure; and displaying a graphical representation of the measured parameter relative to the individualized target range.

Abstract: A method for assessing nerve health during a spinal decompression procedure includes: transmitting electrical stimuli to a nerve; detecting muscle responses evoked by the stimuli; determining multiple nerve function parameters based on the responses; calculating a nerve function index based on a weighted combination of the parameters; storing the index in memory; and displaying the index. The nerve function parameters include at least two of: minimum stimulation threshold, maximal stimulation threshold, and magnitude of maximal muscle response.

Abstract: A method for detecting an artificially induced neuromuscular response in a subject includes receiving a mechanomyography (MMG) output signal from a mechanical sensor in contact with a muscle of the subject; applying one or more conditioning filters to the MMG output signal to generate a conditioned signal and analyzing the conditioned signal to identify one or more candidate waveforms. Each candidate waveform meets one or more analog or digital signal characteristic criteria associated with an artificially induced neuromuscular response. The method then compares a first candidate waveform to a second candidate waveform to determine a degree of similarity between the first and second candidate waveforms, and provides an alert to a user that indicates detection of the artificially induced neuromuscular response when the degree of similarity exceeds a predetermined threshold.

Abstract: An intraoperative neural monitoring system for use during a surgical procedure on a subject includes a mechanical sensor and a processor. The mechanical sensor is configured to monitor a physical motion of a muscle of the subject and provide a mechanomyography (MMG) signal corresponding to the monitored physical motion. The processor is configured to receive the MMG signal, apply a wavelet transform to the MMG signal, and determine, from the output of the wavelet transform, if the monitored physical motion of the muscle is an artificially induced neuromuscular response that is attributable to an applied electrical stimulus. If the processor determines that the monitored physical motion of the muscle is an artificially induced neuromuscular response, it then provides an indication to a user.

Abstract: A method of alerting a user to the existence of an artificially induced neuromuscular response in a subject includes: generating a series of electrical stimuli at a predetermined period with an electrode disposed at a distal end portion of an elongate medical device; detecting a series of mechanomyographic (MMG) responses of the subject using a mechanical sensor, each MMG response indicative of a contraction of a muscle of the subject; determining a degree of statistical confidence that the detected series of MMG responses was artificially induced by the series of electrical stimuli; and outputting, to the user, both an alert that a series of MMG responses has been detected, and the determined degree of statistical confidence that the detected series of MMG responses was artificially induced by the series of electrical stimuli.

Abstract: A method of alerting a user to an artificially induced neuromuscular response in a subject includes generating a mechanomyography (MMG) output signal corresponding to a mechanical motion of a muscle of a subject, applying a wavelet transform to the MMG output signal to determine a convolution coefficient for each of a plurality of daughter wavelets, summing the convolution coefficients determined across the plurality of daughter wavelets at each timestep across a plurality of timesteps to generate a net-convolution coefficient (NCC), identifying one or more peaks in the NCC via a peak finding algorithm, and alerting a user of an artificially induced neuromuscular response following the identification of one or more peaks in the NCC. Each daughter wavelet of the plurality of daughter wavelets is a time-scaled variant of a common mother wavelet, and the convolution coefficient is indicative of a similarity between the daughter wavelet and the MMG output signal.