A system includes a first device having a handle, a head coupled to the handle, a bumper supported by a first end of the head and adapted to be used to strike a patient tendon, a force sensor coupled to the bumper and adapted to generate force data in response to force encountered by the bumper and to generate force data, a first accelerometer coupled to generate head acceleration data in response to movement of the head, and first circuitry to capture the force data and acceleration data. The system may further include second device having a housing adapted to be coupled to the patient limb, a second accelerometer supported by the housing to generate limb acceleration data, and second circuitry to capture the acceleration data.

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.

Surgical visualization systems and related methods are disclosed herein, e.g., for providing visualization during surgical procedures. Systems and methods herein can be used in a wide range of surgical procedures, including spinal surgeries such as minimally-invasive fusion or discectomy procedures. Systems and methods herein can include various features for enhancing end user experience, improving clinical outcomes, or reducing the invasiveness of a surgery. Exemplary features can include access port integration, hands-free operation, active and/or passive lens cleaning, adjustable camera depth, and many others.

A neuromonitoring system utilizing transcutaneous, trans-abdominal nerve root stimulation to monitor the health and status of the motor neural pathways of the lower extremities during the portions of a surgical procedure in which a tissue retraction assembly is used to maintain an operative corridor.

Methods and systems for providing neuromodulation therapy are disclosed. The methods and systems are configured to sense an evoked neural response and use the evoked neural response as feedback for providing neuromodulation therapy. Methods of reducing stimulation artifacts that obscure the sensed evoked neural response are disclosed. The methods of artifact reduction include recording a stimulation artifact in the absence of an evoked neural response, aligning and scaling the stimulation artifact with respect to the obscured signal, and subtracting the aligned and scaled artifact from the obscured signal.

A system is provided for connecting a surgically implantable neurostimulation device to an neurophysiological monitoring device. The system includes an apparatus connecting the neurophysiological monitoring device to the implanted neurostimulation device. The connecting apparatus includes a port couplable to the neurostimulation device and a plurality of electrode pin connectors extending from the port that are connectable to the neurophysiologic monitoring device. Using the connecting apparatus, signals from the neurophysiologic monitoring device can be transmitted for stimulation and responses can be transmitted to the neurophysiologic monitoring device to enable accurate positioning of electrodes of the neurostimulation device.

An example of a system for delivering neurostimulation and sensing one or more signals may include a programming control circuit and a parameter control circuit. The programming control circuit may be configured to control the delivery of the neurostimulation according to stimulation parameters and the sensing of a target neural signal including target neural responses according to sensing parameters. The parameter control circuit may be configured to determine the stimulation parameters and the sensing parameters and may include a recording analyzer. The recording analyzer may be configured to evaluate a sequence of test recording configurations each including a set of recording configuration parameters selected from the stimulation parameters and the sensing parameters and to determine one or more recording configurations suitable for detection of the target neural responses using an outcome of the evaluation.

Examples of the disclosure relate to systems and apparatus that enable a pain profile to be generated. The apparatus comprises means for enabling stimulation of a biological sample using a plurality of electrical stimulating signals. The plurality of electrical stimulating signals comprise different values for one or more parameters and respective electrical stimulating signals are configured to cause a respective change in the biological sample wherein the respective change is optically detectable. The apparatus is also configured to enable measuring of the optically detectable changes caused by the electrical stimulating signals. The optically detectable changes can be measured by using one or more optical devices to detect the optically detectable changes. The measurements obtained by the one or more optical devices and the corresponding values for the one or more parameters of the electrical stimulating signals can be used to generate a pain profile for the biological sample. The pain profile is based on the optically detectable changes caused by the stimulation.

Aspects of the disclosure relate to pledget stimulation/recording electrode assemblies that are particularly useful for automatic periodic stimulation. Embodiments are compatible with nerve monitoring systems to provide continuous stimulation of a nerve during surgery. Disclosed embodiments include an electrode assembly having one or more electrodes rotatably supported by and positioned within a pledget substrate. The flexible pledget substrate conforms and fixates to bioelectric tissue to secure the electrode assembly in position, wrapped around the target tissue. In some embodiments, the pledget substrate includes two bodies, each including at least one electrode, the two bodies being selectively separable so that the bodies can be repositioned with respect to one another. The electrode assembly further includes a lead wire assembly including at least one insulating jacket positioned around a wire core. Optionally, the electrode assembly includes an insulating cup interconnecting the electrode and the insulating jacket.

A method of visualizing spinal nerves includes receiving a 3D image volume depicting a spinal cord and a plurality of spinal nerves. For each spinal nerve, a 2D spinal nerve image is generated by defining a surface within the 3D volume comprising the spinal nerve. The surface is curved such that it passes through the spinal cord while encompassing the spinal nerve. Then, the 2D spinal nerve images are generated based on voxels on the surface included in the 3D volume. A visualization of the 2D spinal images is presented in a graphical user interface that allows each 2D spinal image to be viewed simultaneously.