A system and method is disclosed for measuring muscle reflexes (e.g., a bulbocavernosus reflex) as a tool for identifying/diagnosing dysfunctions (e.g., spinal cord abnormalities, bladder voiding dysfunction, and sexual organ dysfunction) non-invasively by using mechanical stimulation. The system and method includes a probe having a predetermined patient contacting portion, wherein when the contacting portion is moved into contact with a particular area of the patient (e.g., the patient's genitals), the contact induces a muscle reflex. The probe detects the pressure resulting from the contacting portion being abruptly and forcibly brought into contact with the particular area. Such detection is used to electronically initiate capture of electrical responses from a plurality of electrodes placed on the patient's skin in proximity to the particular area. Such electrical responses are processed to determine characteristics of the patient's reflexes of one or more muscles adjacent to the electrodes.

Methods of treating a human patient suffering from Eustachian tube malfunctions are provided. A nasal spray or pharmaceutical composition containing a therapeutically effective amount of betahistine is administered to the patient. The nasal spray or pharmaceutical composition has particular applicability to alleviate the symptoms of Meniere's disease in persons suffering from abnormal Eustachian tube function, but also has an applicability to beneficially improve vascular oxygenation of the inner ear.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

An access port or retractor tube provides access through tissue to a surgical site or field, such as the brain or spine, in a minimally invasive manner. The access port permits a user to clearly view and access the surgical field, including areas medial thereto, in a minimally invasive manner by dilating or separating tissue rather than cutting tissue. Neuro monitoring and neuro navigation are tools essential to neuro surgery to protect vital and eloquent tissues. Combining navigation and monitoring into the access ports/retractor tubes would enable the surgeon to be more precise and efficient during minimally invasive procedures while still being maximally effective in protecting non operative tissues.

A biological information measuring apparatus includes a biomagnetism detector configured to detect biomagnetism of a subject, the biomagnetism detector including a temperature adjustment mechanism; and a radiation detector configured to acquire emitted radiation as digital image data. The radiation detector is disposed between a measurement region of the subject and the biomagnetism detector.

Incorrect connection or mapping of leads' proximal terminals to the ports of an Implantable Stimulator Device (ISD), such as an implantable pulse generator or an external trial stimulator, is a concern, and this disclosure is directed to use of measurement and identification algorithms to either determine that leads are properly connected to their assigned ISD ports, or to determine which leads are connected to the ports even if the leads are not preassigned to the ports. Particular focus is given in the disclosed technique to assessing leads that comprise larger number of electrodes than are supported at each port, and thus have more than one proximal terminal that connect to more than one port of the ISD.

Methods and systems for providing closed loop control of stimulation provided by an implantable stimulator device are disclosed herein. The disclosed methods and systems use a neural feature prediction model to predict a neural feature, which is used as a feedback control variable for adjusting stimulation. The predicted neural feature is determined based on one or more stimulation artifact features. The disclosed methods and systems can be used to provide closed loop feedback in situations, such as sub-perception therapy, when neural features cannot be readily directly measured.

A sensing electrode selection algorithm is disclosed for use with an implantable pulse generator having an electrode array. The algorithm automatically selects optimal sensing electrodes in the array to be used with a pre-determined stimulation therapy appropriate for the patient. The algorithm preferably senses stimulation artifacts using different sensing electrodes, and more specifically different sensing electrode pairs as is appropriate when differential sensing is used. The algorithm further preferably senses these stimulation artifacts with the patient placed in two or more postures. The algorithm processes the stimulation artifact features measured at the different sensing electrodes and at the different postures to automatically determine one or more sensing electrode pairs that best distinguishes the two or more postures given the prescribed stimulation therapy.

An implantable medical device (IMD) includes multiple stimulation engines (SEs) for independently stimulating respective electrode sets of a lead system. A voltage multiplier (VM) is configured to generate an adjustable target voltage at an output node. Each stimulation engine includes first switching circuitry to switchably connect an anodic node of the SE to the VM output node and second switching circuitry to switchably connect a cathodic node of the SE to a current sink circuit. Discharge switching circuitry may be disposed between the anodic and cathodic nodes of each SE. A selector and associated digital control logic block are operative to generate control signals for independently controlling respective SEs such that each SE may be activated to stimulate or discharge a corresponding select set of electrodes independently from or in concert with remaining SEs.

A system and method for modeling patient-specific spinal cord stimulation (SCS) is disclosed. The system and method acquire impedance and evoked compound action potential (ECAP) signals from a lead positioned proximate to a spinal cord (SC). The lead includes at least one electrode. The system and method determine a patient-specific anatomical model based on the impedance and ECAP signals, and transform a dorsal column (DC) map template based on a DC boundary of the patient-specific anatomical model. Further, the system and method map the transformed DC map template to the patient-specific anatomical model. The system and method may also include the algorithms to solve extracellular and intracellular domain electrical fields and propagation along neurons. The system and method may also include the user interfaces to collect patient responses and compare with the patient-specific anatomical model as well as using the patient-specific anatomical model for guiding SCS programming.