Flexible Neural Localization Devices and Methods

Abstract

Described herein are devices, systems and methods for determining if a nerve is nearby a device or portion of a device. The neural stimulation tools described herein are configured to be flexible and low-profile, so that they can be used within body regions that may be tortuous or difficult to reach, such as within a compressed or partially occluded neural foramen. In most cases, these tools described herein are ribbon-shaped and adapted to be manipulated bimanually, for example, by applying force to the ends of the devices from separate locations outside of the patient's body. Thus, in some of the exemplary neural localization devices described herein, the distal end region of the device are configured to couple to the proximal end of a guidewire. One or more surfaces of the devices may include an electrode or multi-polar network of electrodes configured to stimulate only nerves within a predetermined distance of a particular face of the device.

Description

CROSS REFERENCE TO RELATED APPLICATIONS[0001]This patent application is a continuation-in-part to U.S. patent application Ser. No. 12 / 504,545, titled “SPINAL ACCESS AND NEURAL LOCALIZATION”, filed on Jul. 16, 2009; which is a divisional of U.S. patent application Ser. No. 11 / 457,416, titled “SPINAL ACCESS AND NEURAL LOCALIZATION” filed on Jul. 13, 2006; which is a continuation-in-part of U.S. patent application Ser. No. 11 / 251,205, titled “DEVICES AND METHODS FOR TISSUE ACCESS” filed on Oct. 15, 2005; which claims the benefit of U.S. Provisional Patent App. Ser. No. 60 / 681,864, filed May 16, 2005. U.S. patent application Ser. No. 11 / 457,416 is also a continuation-in-part of U.S. patent application Ser. No. 11 / 375,265, titled “METHODS AND APPARATUS FOR TISSUE MODIFICATION” filed Mar. 13, 2006. Each of these applications is herein incorporated by reference in its entirety.[0002]This patent application is a continuation-in-part U.S. patent application Ser. No. 11 / 251,205, titled “DEVIC...

AI Technical Summary

Benefits of technology

[0058]In operation, it may be beneficial to apply force to one or both ends of the device to push the device (and particularly one or more electrodes on the device) “down” (e.g., anteriorly towards the patient's front or ventral side/column). Urging the stimulation region of a ribbon-shaped neural localization device by pushing or pulling the ends may be used as part of any of the methods describe...

Problems solved by technology

Surgical intervention may require the manipulation of one or more medical devices in close proximity to a nerve or nerves, which may risk damage to the nerve tissue.

Although systems for monitoring neural tissue have been described, these systems are typically imprecise.

Further, many of these systems require large current densities (which may also damage tissue) and may be severely limited in their ability to accurately guide surgical procedures.

Because the conductance of biological tissue may vary between individuals, over time in the same individual, and within different tissue regions of the same individual, it has been particularly difficult to predictably regulate the applied curr...

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