The invention consists of a device to evaluate hemodynamic response generated by the spinal cord in response to a suprasensorial stimulus applied to a peripheral nerve (medium or posterior tibial) by the use of functional near-infrared spectroscopy (fNIRS). The device consists of 3 main components, an electrical stimulator, an optical recording unit and a signal processing and control module. The device allows non-invasive, comfortable, harmless, portable, home-based, and low-cost evaluation of changes in local hemodynamic parameters in response to neuronal activation of the spinal cord by electrical stimulation of a peripheral nerve. The invention also includes a corresponding method of using the device and monitoring the spinal function.

A system and method for extracting a cardiac signal from a spinal signal include measuring a spinal signal at one or more electrodes that are connected to a neurostimulator and implanted within a patient's spinal canal and processing the spinal signal to extract the cardiac signal, which includes features that are representative of the patient's cardiac activity. Processing the spinal signal to extract the cardiac signal can include filtering the spinal signal, or use of model reduction schemes such as independent component analysis. The extracted cardiac signal can include a number of features that correspond to an electrocardiogram and can be used to determine the patient's heart rate and/or to detect a cardiac anomaly. Cardiac features that are determined from the cardiac signal can additionally be used to adjust parameters of the stimulation that is provided by the neurostimulator.

A lead body is operable to be implanted proximate a target nerve tissue of a patient. A sensing electrode is configured to sense biopotentials over a first partial circumference of the lead body. A stimulation electrode is configured to deliver stimulation energy over a second partial circumference of the lead body. A signal generator is electrically coupled to the stimulation electrode and a sensing circuit is coupled to the sensing electrode. A processor is operable to apply a stimulation signal to the stimulation electrode via the signal generator and, via the sensing circuit, sense an evoked response to the stimulation signal that propagates along a neural pathway.

Methods and systems for programming stimulation parameters for an implantable medical device for neuromodulation, such as spinal cord stimulation (SCS) are disclosed. The stimulation parameters define user-configured waveforms having at least a first phase having a first polarity and a second phase having a second polarity, wherein the first and second phases are separated by an interphase interval (IPI). By delivering user-configured waveforms with different IPIs, stimulation geometry, and other waveform settings, therapeutic asynchronous activation of dorsal column fibers can be obtained.

Disclosed herein are systems and methods of analyzing 3D structure of a portion of the CNS. An analytics module may be used to calculate one or more metrics the describe changes in the 3D structure of a CNS structure over time. The one or more metrics may be used to identify patterns of structural change prior to progressive symptom development. Healthcare providers may use the one or more metrics and or patterns of structural change to diagnose neurological conditions, track the progress of neurological conditions in the patient, and determine the patient's risk of progressive disease development. The 3D structure analytics techniques described herein may also be used to develop treatments and create a care delivery that is individualized for each patient.

A medical electrode device for implantation comprises a carrier formed from an electrically insulating material and defining a surface extending along a plane of extension, and at least one electrode arranged on the carrier for emitting an electrical stimulation signal and/or receiving an electrical sense signal. The at least one electrode comprises first and section wall sections. Said first wall section, in a cross-section along a cross-sectional plane perpendicular to said plane of extension, extends straight along a perpendicular direction with respect to said plane of extension or at an oblique angle with respect to said perpendicular direction, the first wall section in contact with the carrier electrically insulating material. Said second wall section, in said cross-section along said cross-sectional plane perpendicular to said plane of extension, adjoins said first wall section and is curved, the second wall section not in contact with the carrier electrically insulating material.

A system and method for extracting a cardiac signal from a spinal signal include measuring a spinal signal at one or more electrodes that are connected to a neurostimulator and implanted within a patient's spinal canal and processing the spinal signal to extract the cardiac signal, which includes features that are representative of the patient's cardiac activity. Processing the spinal signal to extract the cardiac signal can include filtering the spinal signal, or use of model reduction schemes such as independent component analysis. The extracted cardiac signal can include a number of features that correspond to an electrocardiogram and can be used to determine the patient's heart rate and/or to detect a cardiac anomaly. Cardiac features that are determined from the cardiac signal can additionally be used to adjust parameters of the stimulation that is provided by the neurostimulator.

The present invention relates to a system and methods generally aimed at surgery. More particularly, the present invention is directed at a system and related methods for performing surgical procedures and assessments involving the use of neurophysiology.

A method for performing percutaneous spinal interbody fusion on a spine of a patient can include inserting without direct visualization a neuro-monitoring dilating probe into the patient, performing neuro-monitoring via the neuro-monitoring dilating probe, advancing the neuro-monitoring dilating probe into a disc space, passing a second dilator over the neuro-monitoring dilating probe, and advancing the second dilator into the disc space. A kit for performing percutaneous spinal interbody fusion can include a neuro-monitoring dilating probe, a second dilator, a tissue removal tool, an access portal comprising an adjustable depth stop, and a discectomy verification device.

In Spinal Cord Stimulation (SCS) systems having sensing capability, conventional wisdom seeks to minimize or avoid sensing of stimulation artifacts caused by the stimulation. Despite this, the present disclosure recognizes that stimulation artifacts in and of itself can include useful information relevant to operation of the SCS implant and/or the status of the patient. In particular, stimulation artifact features as sensed canbe used to determine a posture or activity of the patient, or more generally to adjust the stimulation program that the SCS implant is providing. Furthermore, sensing of stimulation artifact features can be as useful as, and possibly even more useful than, information gleaned from sensing neural responses to stimulation, such as Evoked Compound Action Potentials (ECAPs).