A method of providing a channel in nervous tissue filled with an aqueous gel for implantation of a microelectrode or other medical device lacking sufficient physical stability for direct implantation by insertion, comprises providing an apparatus comprising an oblong rigid pin covered by a dry gel forming agent; locating a target in the tissue; defining a straight insertion path a desired tissue insertion point and the target; aligning the pin with its end foremost with the insertion path; inserting the pin into the tissue to a position near or at the target; allowing sufficient time to pass for a gel to be formed around the pin, withdrawing the pin. Also disclosed is a corresponding channel; a method of implantation of a microelectrode or microprobe into nervous tissue via the channel; a corresponding method of implantation of living cells; a corresponding apparatus for forming the channel.

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.

Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.

An electrode assembly (preferably in the form of a nerve cuff) comprises a base with first and second arms extending from opposite sides of the base, and which, in combination, define an arc. First and second electrically conductive electrodes extend along the inner surface of the first and second arms. Each electrode can comprise a single length of foil can or can comprise multiple discrete foil segments. The foils are electrically isolated from each other. Electrical wires, which are in electrical communication with the each of the foils, extend from the nerve cuff and are adapted to be electrically connected to a signal monitor. When the nerve cuff is applied to a nerve, the foils, in combination, substantially surround the nerve, with the first and second electrodes being on opposite sides of the nerve from each other. Also disclosed is a method of using the nerve cuff to monitor a nerve during a lumbar spinal surgery while the patient is anesthetized and paralyzed.

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 thh: \e electrodes.

The subject matter of the present disclosure generally relates to techniques for neuromodulation of a tissue that include applying energy (e.g., ultrasound energy) into the tissue to cause altered activity at a synapse between a neuron and a non-neuronal cell.

Embodiments of the present invention relate to a novel approach to automatically detect the occurrence of evoked potentials, quantify the attributes of the signal and visualize the effect across a high number of spinal cord epidural stimulation parameters. This new method is designed to automate the current process for performing this task that has been accomplished manually by data analysts through observation of the raw EMG signals, which is laborious and time-consuming as well as being prone to human errors. The proposed method provides fast and accurate framework for activation detection and visualization of the results within five main algorithms.

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.

One embodiment provides a system controller circuitry for mitigating a neurophysiological disorder. The system controller circuitry includes an optimization module, a feedback control module, and a model update module. The optimization module is configured to predict a sequence of control inputs based, at least in part, on a fractional order model of a neurophysiological system. A duration of the predicted sequence of control inputs corresponds to a prediction horizon. The feedback control module is configured to provide at least a portion of the sequence of control inputs to the neurophysiological system based, at least in part, on a current state of the neurophysiological system. A duration of the at least a portion corresponds to a control horizon. The model update module is configured to update one or more of a model parameter and/or an objective function parameter at an update interval, based, at least in part, on a recent state of the neurophysiological system.