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 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.

A method and device for modulating the autonomic nervous system adjacent a pericardial space to treat cardiac arrhythmia includes a treatment source arranged to supply a treatment medium, a catheter having an end sized for insertion into the pericardial space, a medium delivery assembly having a distal end arranged to be positioned by the catheter into the pericardium, with the distal end of the delivery assembly comprising a delivery tip arranged to extend away from the distal end of the catheter into the pericardial space. A connector operatively couples the delivery tip of the medium delivery assembly to the treatment source, and the delivery tip of the medium delivery assembly including a plurality of delivery points for delivering the treatment medium at a plurality of treatment areas within the pericardial space. The device performs modulation or ablation of the autonomic nervous system at selected treatment areas within the pericardium.

A method and device for modulating the autonomic nervous system adjacent a pericardial space to treat cardiac arrhythmia includes a treatment source arranged to supply a treatment medium, a catheter having an end sized for insertion into the pericardial space, a medium delivery assembly having a distal end arranged to be positioned by the catheter into the pericardium, with the distal end of the delivery assembly comprising a delivery tip arranged to extend away from the distal end of the catheter into the pericardial space. A connector operatively couples the delivery tip of the medium delivery assembly to the treatment source, and the delivery tip of the medium delivery assembly including a plurality of delivery points for delivering the treatment medium at a plurality of treatment areas within the pericardial space. The device performs modulation or ablation of the autonomic nervous system at selected treatment areas within the pericardium.

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.

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.

An apparatus and method is provided for intraoperative tissue stimulation during port-based surgery. The apparatus includes an access port and electrical terminals attached to the access port for tissue stimulation. In an alternative embodiment, the apparatus may include an access port, with or without electrical terminals attached to the access port for tissue stimulation, and electrocorticography sensors attached to the access port. The method includes inserting an access port into a tissue, applying an electrical potential to the tissue using electrical terminals attached to the access port, and measuring consequent neural activity using electrocorticography sensors attached to the access port.

An apparatus and method is provided for intraoperative tissue stimulation during port-based surgery. The apparatus includes an access port and electrical terminals attached to the access port for tissue stimulation. In an alternative embodiment, the apparatus may include an access port, with or without electrical terminals attached to the access port for tissue stimulation, and electrocorticography sensors attached to the access port. The method includes inserting an access port into a tissue, applying an electrical potential to the tissue using electrical terminals attached to the access port, and measuring consequent neural activity using electrocorticography sensors attached to the access port.

A method for determining a lowest stimulation threshold current level in a group of channels of a neuromonitoring device. The method includes stimulating tissue at a current level from a predetermined range of current levels as a sequence of pulses delivered at a frequency. The stimulating includes increasing the current level of each pulse in the sequence of pulses from an immediately preceding pulse by a first current increment. The method includes determining that a first evocation pulse from the sequence of pulses evokes a first muscular response. The method includes stimulating the tissue with a second evocation pulse from the sequence of pulses to evoke a second muscular response. The stimulating includes decreasing the frequency of the delivery of each pulse in the sequence of pulses and increasing the current level of each pulse in the sequence of pulses from the immediately preceding pulse by a second current increment. The method includes determining that the second evocation pulse from the sequence of pulses evokes the second muscular response.

A method for determining a lowest stimulation threshold current level in a group of channels of a neuromonitoring device. The method includes stimulating tissue at a current level from a predetermined range of current levels as a sequence of pulses delivered at a frequency. The stimulating includes increasing the current level of each pulse in the sequence of pulses from an immediately preceding pulse by a first current increment. The method includes determining that a first evocation pulse from the sequence of pulses evokes a first muscular response. The method includes stimulating the tissue with a second evocation pulse from the sequence of pulses to evoke a second muscular response. The stimulating includes decreasing the frequency of the delivery of each pulse in the sequence of pulses and increasing the current level of each pulse in the sequence of pulses from the immediately preceding pulse by a second current increment. The method includes determining that the second evocation pulse from the sequence of pulses evokes the second muscular response.