A harness comprising a patient module connector, an extremity hub; a cable branch including a plurality of channel pairs. The cable branch includes a first end coupled to the patient module connector and a second end coupled to the extremity hub. The harness comprises a monitoring cable configured to attach and detach from the extremity hub.

FIELD

This disclosure describes a harness and a monitoring cable for use during a surgical procedure.

BACKGROUND

Electromyography (EMG) is the study of the electrical activity of muscles. It is a test used to help assess the health and function of nerves and/or muscles. EMG can be used by a surgeon to assess proper pedicle screw placement in fusion surgeries to help reduce the chance of nerve damage, or to aid in assessing nerve proximity and location during surgical approaches. Typically, one or more hardware and software components are used to assist in performing an EMG test during a surgical procedure.

SUMMARY

In one embodiment, a harness comprises a patient module connector, an extremity hub, a cable branch including a plurality of channel pairs. The cable branch includes a first end coupled to the patient module connector and a second end coupled to the extremity hub. The harness comprises a monitoring cable configured to attach and detach from the extremity hub. The monitoring cable includes a first electrode wire, a second electrode wire, and a housing. The housing is configured to receive a first end of the first electrode wire and a first end of the second electrode wire. The housing includes a first aperture and a second aperture along an axis of the housing. The monitoring cable includes a body that includes a channel formed by an aperture along a first axis of the body. The channel includes a first retention element located on a first surface of the channel and along a second axis of the body. The channel includes a second retention element located along a second surface of the channel and along the second axis. The first axis and the second axis are perpendicular. The body is configured to slidably receive the housing. The housing is held in a fixed position based on insertion of the first retention element within the first aperture and insertion of the second retention element within the second aperture.

In another embodiment, a monitoring cable comprises a first electrode wire, a second electrode wire, and a housing. The housing is configured to receive a first end of the first electrode wire and a first end of the second electrode wire. The housing includes a first aperture and a second aperture along an axis of the housing. The monitoring cable comprises a body. The body includes a channel formed by an aperture along a first axis of the body. The channel includes a first retention element located on a first surface of the channel and along a second axis of the body. The aperture includes a second retention element located along a second surface of the channel and along the second axis. The first axis and the second axis are perpendicular. The body is configured to slidably receive the housing. The housing is held in a fixed position based on insertion of the first retention element within the first aperture and insertion of the second retention element within the second aperture.

In another embodiment, a harness comprises a patient module connector, an extremity hub, and a cable branch including a plurality of channel pairs. The cable branch includes a first end coupled to the patient module connector and a second end coupled to the extremity hub. The harness includes a monitoring cable. The monitoring cable is configured to attach and detach from the extremity hub. The monitoring cable includes a plurality of electrode wires and a plurality of housings configured to receive the plurality of electrode wires. The plurality of housings includes a plurality of apertures. The monitoring cable includes a body. The body includes a plurality of channels formed by a plurality of apertures along the body. The plurality of channels include a plurality of retention elements located on surfaces of the plurality of channels. The body is configured to slidably receive the plurality of housings and hold the plurality of housings in fixed positions based on insertion of the plurality of retention elements within the plurality of apertures.

DETAILED DESCRIPTION

Illustrative embodiments of the invention are described below. In the interest of clarity, not all features of an actual implementation are described in this specification. It will of course be appreciated that in the development of any such actual embodiment, numerous implementation-specific decisions must be made to active the developers' specific goals, such as compliance with system-related and business-related constraints, which will vary from one implementation to another. Moreover, it will be appreciated that such a development effort might be complex and time-consuming, but nevertheless be a routine undertaking for those of ordinary skill in the art having the benefit of this disclosure. It is furthermore to be readily understood that, although discussed below primarily within the context of spinal surgery, the systems and methods of the present invention may be employed in any number of anatomical settings to provide access to any number of different surgical target sites throughout the body.

Examples described herein include a harness and a monitoring cable for performing a surgical procedure. In one example, a harness for use during a surgical procedure includes a patient module connector. The patient module connector is configured to connect to a monitoring system for providing various neurophysiologic assessments during the surgical procedure. The harness also includes an extremity hub. The extremity hub includes one or more connectors for mating with one or more wires connected to one or more electrodes. The harness also includes a cable branch including a plurality of channel pairs. The plurality of channel pairs are configured for providing one or more stimulation signals to various locations of a body of a patient during the surgical procedure. The plurality of channel pairs are also configured for acquiring one or more responses based on the one or more stimulation signals. In one example, the responses are provided to the monitoring system for analysis and for providing feedback to a user during the surgical procedure. In one example, the cable branch includes a first end coupled to the patient module connector and a second end coupled to the extremity hub. In another example, the harness includes multiple cable branches that are also coupled to the patient module connector and the extremity hub as described herein.

The harness also includes a monitoring cable configured to attach and detach from the extremity hub. In one example, the monitoring cable includes at least a first electrode wire and a second electrode wire. The monitoring cable also includes a housing that is integrally molded to receive a first end of the first electrode wire and a first end of the second electrode wire. In one embodiment, the housing includes a first aperture and a second aperture along an axis of the housing. In another embodiment, the housing includes additional apertures along one or more axes of the housing. The monitoring cable also includes a body that includes an aperture along a first axis of the body. The aperture includes a first retention element located on a first surface of the aperture and along a second axis of the body. The aperture also includes a second retention element along a second surface of the aperture and along the second axis. In one embodiment, the first axis and the second axis are perpendicular. The body of the monitoring cable is configured to slidably receive the housing. The body is held in a fixed position based on insertion of the first retention element within the first aperture and insertion of the second retention element within the second aperture.

Referring now to the figures,FIG.1is a diagram of an example harness100for performing a surgical procedure. The example harness100includes a patient module connector102, cable branches104,106,108,110, and112, and extremity hubs114,116,118,120, and122.

The patient module connector102includes a connection point to a patient module (not shown). In one example, the patient module connector102includes 70 distinct channels. Continuing with this example, the patient module connector102includes a programmable memory device. In one example, the programmable memory device is an electrically erasable programmable read-only memory. In one example, there are numerous stimulation channels for providing a stimulation signal to the body of a patient during a surgical procedure and numerous acquisition channels for acquiring a response to a stimulation signal provided to the body of the patient.

The cable branches104,106,108,110, and112are designed to utilize the same cable construction. In one example, the cable branch104includes six acquisition channel pairs and one stimulation channel pair. Continuing with this example, the insulation surrounding the stimulation channel pair needs to ensure 1500 VAC isolation between the six channel acquisition channel pairs. In one example, cable branches106,110, and112are configured in a similar manner as described above with regard to cable branch104. In this example, cable branch108has an inverted layout that includes one acquisition channel pair, five stimulation channel pairs, and one channel pair for ground.

The extremity hubs114,116,118,120, and122are designed to utilize the same overmold design. The same overmold design enables the extremity hubs to use the same tool. This also optimizes manufacturing costs as well as ensuring a reproducible design. In one example, the extremity hubs114,116,120, and122have the same connector layout.

FIG.2illustrates a front view of the extremity hub114ofFIG.1. As shown inFIG.2, the extremity hub114includes seven pairs of dual connector female receptacles202,204,206,208,210,212, and214. There are four dual connector female receptacles202,204,206, and208in a vertical orientation along a first axis of the extremity hub114and three dual connector female receptacles210,212, and214in a horizontal orientation along a second axis of the extremity hub114. As shown inFIG.2, the dual connector female receptacle202includes retention elements216,218,220, and222. The dual connector female receptacle204includes retention elements224,226,228, and230. The dual connector female receptacle206includes retention elements232,234,236, and238. The dual connector female receptacle208includes retention elements240,242,244, and246. The dual connector female receptacle210includes retention elements248,250,252, and254. The dual connector female receptacle212includes retention elements256,258,260, and262. The dual connector female receptacle214includes retention elements264,266,268, and270. In one example, the extremity hubs116,120, and122the same connector layout to the connector layout of extremity hub114. In one example, the extremity hub118has a similar connector layout to the connector layouts of extremity hubs114,116,120, and122except for two of the dual female connector receptacles along the second axis.

FIG.3illustrates a front view of the extremity hub118ofFIG.1. As shown inFIG.3, the extremity hub118includes five pairs of dual connector female receptacles302,304,306,308, and310. In place of the other two dual female connector receptacles of the extremity hub114, the extremity hub118includes a pair of Deutsches Institut für Normung (DIN) connections points312and314. In one example, the DIN connection points provide connection points for motor evoked potential (MEP) cranial stimulation leads. In another example, the DIN connection points provide connection points for transabdominal stimulation and generation of transabdominal muscle action potentials.

FIG.4illustrates an example housing402that includes an electrode. The housing402includes apertures404,406,408, and410. The housing402also is integrally formed with electrode wires412and414. The housing402includes apertures404and406along an axis416and apertures410and408along an axis418. As shown inFIG.4, the axis416is parallel to axis418. However, it is envisioned that the apertures404,406,408, and410may be positioned in various configurations along the surface of housing402. By way of example, one or more apertures may be included or removed from the apertures as shown inFIG.4.

The housing402may be attached to or detached to one of the extremity hubs114,116,118,120, and122ofFIG.1. In one example, the housing402is attached to a dual connector female receptacle of one of the extremity hubs114,116,118,120, and122. By way of example, when the housing402is attached to the extremity hub114, the apertures406and408are configured to receive the retention elements216and220of dual connector female receptacle202of extremity hub114ofFIG.2. Continuing with this example, the apertures404and410are configured to receive to receive the retention elements218and222of dual connector female receptacle202. For example,FIG.5illustrates a cross-sectional view of the housing402attached to the extremity hub114ofFIG.2. The retention elements216,218,220, and220of the dual connector female receptacle202ensure that an electrical connection is maintained between the electrode of the housing402and the extremity hub114.

FIG.6illustrates an example body626configured to receive one to four housings (e.g., housing402). The body626includes an aperture632located along an axis640of the body626, an aperture634located along an axis642of the body626, an aperture636located along an axis644of the body626, and an aperture638located along an axis646of the body626. Each of the apertures632,634,636, and638form corresponding channels633,635,637, and639within the body626. The body626includes a first tab628coupled to a first surface of the body626and a second tab630coupled to a second surface of the body326. As shown inFIG.6, the first surface is opposite of the second surface. In one example, the first tab628and the second tab630are configured to attach and detach from an extremity hub (e.g., extremity hubs114,116,118,120, and122). For example,FIG.7illustrates a cross-sectional view of the housing402attached to the body626. As shown inFIG.7, the body626is attached to the extremity hub114ofFIG.2at a first location728via the first tab628and a second location730via the second tab630.

Referring back toFIG.6, the channel633formed by the aperture332includes retention elements652and654along a first surface of the channel633and retention elements656and658along a second surface of the channel633. In one example, the retention elements652,654,656, and658are similar to the retention elements (e.g.,216,218,220, and222) of the dual female connector receptacles of the extremity hubs (e.g., extremity hub114ofFIG.2, extremity hub118ofFIG.3). As shown inFIG.6, the retention elements652and656are located along an axis648. The retention elements654and658are located along an axis650. The axis640is perpendicular to the axes648and650.

The channel635formed by the aperture634includes retention elements660and662along a first surface of the channel635and retention elements664and666along a second surface of the channel635. Retention elements660and664are located along the axis648. Retention elements662and666are located along the axis650. The axis642is parallel to axis640and perpendicular to the axes648and650.

The channel637formed by the aperture636includes retention elements668and670along a first surface of the channel637and retention elements672and674along a second surface of the channel637. Retention elements668and672are located along the axis648. Retention elements670and674are located along the axis650. The axis644is parallel to axis642and perpendicular to the axes648and650.

The channel639formed by the aperture638includes retention elements676and678along a first surface of the channel639and retention elements680and682along a second surface of the channel639. Retention elements676and680are located along the axis648. Retention elements678and682are located along the axis650. The axis646is parallel to axis644and perpendicular to the axes648and650.

FIG.8illustrates an example monitoring cable800that may be attached to or detached from an extremity hub (e.g., extremity hubs114,116,118,120, and122). The monitoring cable800includes electrode wires802,804,806,808,810,812,814, and816, housings818,820,822, and824, and body826. In one example, the housings818,820,822, and824are configured as the housing402ofFIG.4. In one example, the body826is configured as the body626ofFIG.6.

Prior to commencing a surgical procedure, the electrode wires802,804,806,808,810,812,814, and816are configured to monitor various parts of a patient's body. In one example, in surgical procedure that involves a portion of the cervical spine, the electrodes associated with electrode wires802and804may be placed at the trapezius, the electrodes associated with electrode wires806and808may be placed at the triceps, the electrodes associated with electrode wires810and812may be placed at the abductor pollicisbrevisand the abductor digiti minimi, and the electrodes associated with electrode wires814and816at the deltoid. In another example, in a surgical procedure that involves a portion of the lumbar spine, the electrodes associated with electrode wires802and804may be placed at the vastus medialis, the electrodes associated with electrode wires806and808may be placed at the biceps femoris, the electrodes associated with electrode wires810and812may be placed at the gastroc medial, and the electrodes associated with electrode wires814and816at the tibialis anterior.

Housings818,820,822, and824are configured to receive a first end of a first electrode wire and a first end of a second electrode wire. The housings818,820,822, and824are also configured to attach to and detach from the body826. For example, as shown inFIG.9, housing818has been detached from the body826while housings820,822, and824are shown attached to the body826. The ability to remove a single housing from the body826while allowing the other housings to remain connected to the body826helps to reduce the time necessary to prepare a patient for a surgical procedure. In one scenario, a user may receive an alert via monitoring system (not shown) coupled to the harness100that indicates a problem with the electrodes associated with electrode wires802and804corresponding to housing818. In this scenario, the user may choose to remove only housing818and replace it with another housing without having to take the time to replace all the other electrodes and corresponding housings.

Referring back toFIG.8, the body826includes a first tab828coupled to a first surface of the body826and a second tab830coupled to a second surface of the body826. As shown inFIG.8, the first surface is opposite of the second surface. In one example, the first tab828and the second tab830are configured to attach and detach from an extremity hub (e.g., extremity hubs114,116,118,120, and122).

FIG.10illustrates a top view of a monitoring cable1000. In one example, the monitoring cable1000is similar to the monitoring cable800ofFIG.8. As shown inFIG.10, the body826is configured to slidably receive housings818,820,822, and824. The housings818,820,8322, and824are held in a fixed position based on insertion of the retention elements852,856,860,864,868,872,876, and880within apertures (e.g., apertures402,406,408, and410of housing402ofFIG.4) of housings818,820,822, and824.

FIG.11illustrates the harness100ofFIG.1coupled to monitoring cables1104,1108,1110, and1112and not coupled to monitoring cable1106. In one example, the monitoring cables1104,1106,1108,1110, and1112are similar to the monitoring cable800ofFIG.8and the monitoring cable1000ofFIG.10. As shown inFIG.11, the monitoring cables1104,1106,1108,1110, and1112are configured to attach and detach from the extremity hubs114,116,118,120, and122in a manner as described above.