Patent ID: 8092455

Claim:
An apparatus, comprising: a tool portion configured to operate relative to bone tissue of a patient, wherein said tool portion includes an insulated shaft extending along a longitudinal axis and comprising an electrically conductive member with a non-insulated tip, wherein said shaft carries an electrical signal to said tip and into the patient; a handle portion, removably and operably coupled to said tool portion, incorporating an operating system for rotational operation of said tool portion about the longitudinal axis, said handle portion configured to electrically insulate a user of said tool portion from said electrical signal; and a nerve monitoring system connected to said handle portion, said nerve monitoring system configured to induce an electrical current as said electrical signal at said non-insulated tip, wherein said nerve monitoring system is operable to detect a neural element threshold of a neural element of the patient as a function of said electrical signal, said detection based on an observation of a muscle reaction of the patient to the electrical current interacting with a nerve or based on a detected increase in the electrical current flowing through said non-insulated tip, and provide a signal to said operating system of said handle portion to change an operative mode related to said rotational operation of said tool portion upon detection of the neural element threshold, wherein said change of said operative mode includes reversing a direction of rotation of said tool portion about said longitudinal axis to protect the neural element of the patient.