One embodiment includes a method for monitoring nerve tissue which includes inserting a dilator into muscle, the dilator including first and second electrodes at the distal tip. While the dilator is in muscle, a system may communicate (a) a first series of unequal current amplitude applications (e.g., a series including 0.5, 7, 3, 5 mA applications) to the first electrode to produce at least a first evoked potential (e.g., a MAP or NAP), and (b) a second series of unequal current amplitude applications to the second electrode to produce at least a second evoked potential. The method further includes sensing the first and second evoked potentials and determining a relative location of a nerve based on the sensing of at least one of the first and second evoked potentials.

Methods, systems, devices, assemblies and apparatuses for treatment of hypertension in a patient using renal denervation. The therapeutic assembly includes an energy delivery element. The energy delivery element is configured to provide renal denervation energy to a nerve within a blood vessel of a patient. The therapeutic assembly includes a controller. The controller is coupled to the energy delivery element. The controller is configured to determine that the hypertension in the patient is orthostatic. The controller is configured to apply renal denervation energy to the patient using the energy delivery element.

Hyperspectral, fluorescence, and laser mapping imaging with a minimal area image sensor are disclosed. A system includes an emitter for emitting pulses of electromagnetic radiation and an image sensor comprising a pixel array for sensing reflected electromagnetic radiation, wherein the pixel array comprises active pixels and optical black pixels. The system includes a black clamp circuit providing offset control for data generated by the pixel array. The system is such that at least a portion of the pulses of electromagnetic radiation emitted by the emitter comprises one or more of: electromagnetic radiation having a wavelength from about 513 nm to about 545 nm; electromagnetic radiation having a wavelength from about 565 nm to about 585 nm; electromagnetic radiation having a wavelength from about 900 nm to about 1000 nm; an excitation wavelength of electromagnetic radiation that causes a reagent to fluoresce; or a laser mapping pattern.

A detection system can include a device, a circuit, and at least one indicator. The device can include polymer needle having a distal end and a proximal end. A needle lumen can be extended along a longitudinal axis of the polymer needle. The distal end can include an insertion tip. An elongate sleeve can include a first end and a second end. The polymer needle can be located within an inner bore of the elongate sleeve. The insertion tip of the polymer needle can be disposed at a distance from the elongate sleeve. A first electrode can be coupled to the device and a second electrode can be electrically isolated from the first electrode. The circuit can be configured to provide a signal based on an electrical characteristic between the first electrode and the second electrode. At least one indicator can be communicatively coupled to the circuit and configured to provide an output based on the signal.

Apparatus comprises: (a) a longitudinal member (32), having a distal portion (34); (b) a plurality of electrodes (38) disposed on the distal portion of the longitudinal member, such that a first electrode (38a) of the plurality of electrodes is disposed distally along the longitudinal member from a second electrode (38b) of the plurality of electrodes; and (c) a controller (40). The controller comprises an actuator, and circuitry (42) electrically connected to the electrodes via the longitudinal member. The actuator is configured to move the longitudinal member in discrete incremental movements such that for each incremental movement, (i) before the incremental movement the first electrode is disposed in a starting position, (ii) during each incremental movement the actuator moves second electrode toward the starting position, and (iii) at the end of each incremental movement the second electrode is stationary at the starting position.

A multi-portal method for treating a subject's spine includes distracting adjacent vertebrae using a distraction instrument positioned at a first entrance along the subject to enlarge an intervertebral space between the adjacent vertebrae. An interbody fusion implant can be delivered into the enlarged intervertebral space. The interbody fusion implant can be positioned directly between vertebral bodies of the adjacent vertebrae while endoscopically viewing the interbody fusion implant using an endoscopic instrument. The patient's spine can be visualized using endoscopic techniques to view, for example, the spine, tissue, instruments, and implants before, during, and after implantation, or the like. The visualization can help a physician throughout the surgical procedure to improve patient outcome.

Treatment systems are provided, which comprise a treatment element applying a treatment to a tissue, a stimulation element optically stimulating nerves in the tissue, a sensing unit sensing an electrical signal produced by nerves in the tissue in response to the optical stimulation, and a control unit controlling the application of the treatment according to the sensed signal. The systems and methods are used to avoid damaging nerves by sensing them during operation and immediately before local treatment application and preventing energy emission when the treatment tool is too close to specified nerves. Additional electric stimulation may be provided to enable avoidance of nerve damages on a larger scale, the treatment may be applied by a cold laser, and the control unit may control the treatment in realtime and in a closed loop and immediate prevent further treatment upon sensing optically stimulated nerves.

A neuromuscular sensing method includes transmitting an electrical stimulus from a distal end portion of an elongate stimulator extending within an intracorporeal treatment area of a subject and detecting an artificially induced response of at least two muscles of the subject in response to the transmitted electrical stimulus, each response being detected by a respective sensor in mechanical communication with the muscle. A graphical user interface (GUI) is transitioned from a first state to a second state; the first state indicating to the transmission of a stimulus with no artificially induced response detected, and the second state indicating the detection of the artificially induced response of the at least two muscles, and further identifying one of the at least two muscles as a primary muscle response.

Methods and systems useful for machine learning assisted imaging and detection of peripheral nerves comprising reflectance imaging spectroscopy. The method can be conducted label-free and in real-time.

A system, including various apparatus and methods, for surgical navigation is provided. The system is configured to track the spine of a patient by capturing images via one or more cameras. The cameras are configured to capture images of one or more arrays. The system transmits the images to a computer system. The one or more arrays are releasably secured with the spine of the patient, such as by a spine pin or a spine clamp. The system can determine the spatial position and orientation of relevant anatomical features, implants, and instruments using and processing the captured images.