Surgical navigational and neuromonitoring instrument

Abstract

The invention relates to a surgical instrument capable of applying an electrostimulation to a neural structure. The surgical instrument also has a tracking system associated therewith to provide navigational tracking during a surgical procedure.

1 .- 36 . (canceled) 
     
     
         37 . A surgical tool capable of applying electrostimulation comprising:
 an instrument having a handle portion and a body member extending from the handle portion, the body member having an electrically conductive portion connected to an energy source and capable of applying electrostimulation energy provided by the energy source; and   a tracking system associated with the instrument and operative to provide information regarding a position of the instrument on a display, the tracking system being configured to detect neurological information based on electrostimulation energy applied by the instrument and superimpose the neurological information on the instrument position on the display.   
     
     
         38 . The surgical tool of  claim 37  wherein the handle portion includes an electrical lead connectable to the energy source, wherein the energy source is remote from the instrument. 
     
     
         39 . The surgical tool of  claim 37  wherein the energy source includes a battery pack disposed within the handle portion. 
     
     
         40 . The surgical tool of  claim 37  wherein the body member includes an electrically insulated outer surface area, and wherein the electrically conductive portion extends from the handle portion and internal to the insulated outer surface. 
     
     
         41 . The surgical tool of  claim 37  wherein the tracking system includes a set of reflectors connected to the instrument and operative to reflect energy that can be detected and analyzed by a navigation system to determine a real-time position of the instrument. 
     
     
         42 . The surgical tool of  claim 41  wherein the set of reflectors are connected to an outer surface of the handle portion. 
     
     
         43 . The surgical tool of  claim 37  wherein the tracking system includes a set of emitters connected to the instrument and operative to provide detectable energy that can be analyzed by a navigational system to determine a real-time position of the instrument. 
     
     
         44 . The surgical tool of  claim 43  wherein the set of emitters are powered by electrical energy provided to the instrument by the energy source. 
     
     
         45 . The surgical tool of  claim 37  wherein the instrument is capable of applying bi-polar electrostimulation. 
     
     
         46 . The surgical tool of  claim 37  wherein the instrument is a surgical probe. 
     
     
         47 . The surgical tool of  claim 37  wherein the instrument is a surgical tap. 
     
     
         48 . The surgical tool of  claim 37  wherein the instrument is a screwdriver. 
     
     
         49 . The surgical tool of  claim 37  wherein the instrument is a retractor. 
     
     
         50 . The surgical tool of  claim 37  wherein the instrument is capable of applying uni-polar electrostimulation. 
     
     
         51 . A surgical tool assembly comprising:
 an instrument having a handle, an insulating sheath, and a conductive member connected to the handle and internal to the insulating sheath, wherein a portion of the conductive member projects distally from the insulating sheath;   an energy source operable with the instrument and designed to provide electrical energy to the conductive member for application of electrostimulation to a neural structure when the neural structure is in contact with the portion of the conductive member and electrical energy is provided to the conductive member; and   a tracking system associated with the instrument and operative to provide information regarding a position of the instrument on a display, the tracking system being configured to detect neurological information based on the electrostimulation energy applied by the instrument and superimpose the neurological information on the instrument position information on the display.   
     
     
         52 . The surgical tool assembly of  claim 51  wherein the energy source is a battery. 
     
     
         53 . The surgical tool assembly of  claim 52  wherein the battery is housed within the handle. 
     
     
         54 . The surgical tool assembly of  claim 51  wherein the insulating sheath includes a non-conductive coating on the conductive member. 
     
     
         55 . The surgical tool assembly of  claim 51  wherein the instrument is one of a probe, a retractor, a screwdriver, and a tap. 
     
     
         56 . The surgical tool assembly of  claim 51  wherein the instrument is capable of applying bipolar or unipolar electrostimulation to the neural structure. 
     
     
         57 . The surgical tool assembly of  claim 51  wherein the tracking system includes active, passive, or a combination of active and passive tracking elements. 
     
     
         58 . A neuromonitoring system capable of applying electrostimuation energy to a neural structure, the system comprising:
 an instrument comprising:
 a handle and a stylet extending from a distal end of the handle; and 
 a navigational sensor associated with at least one of the handle and the stylet, the navigation sensor operative to provide feedback regarding a position of the instrument, and 
   a tracking system associated with the instrument and operative to provide information regarding a position of the instrument on a display, the tracking system being configured to detect neurological information based on the electrostimulation energy applied by the instrument and superimpose the neurological information on the instrument position information on the display.   
     
     
         59 . The neuromonitoring probe of  claim 58  further comprising a cannula of insulating material extending from the distal end of the handle and wherein the stylet is disposed within a lumen of the cannula. 
     
     
         60 . The neuromonitoring probe of  claim 59  wherein the navigational sensor is secured to an outer surface of the cannula. 
     
     
         61 . The neuromonitoring probe of  claim 60  wherein the navigational sensor is a reflector. 
     
     
         62 . The neuromonitoring probe of  claim 58  wherein the handle houses an energy source that provides energy to the stylet for the application of electrostimulation to a neural structure. 
     
     
         63 . The neuromonitoring probe of  claim 63  wherein the energy source is a battery. 
     
     
         64 . The neuromonitoring probe of  claim 58  wherein the stylet includes a pointed distal end capable of forming a hole in a pedicle.