Neuralytix iD3 is an MMG-based technology designed to enhance intraoperative surgical decision-making. The technology assists surgeons with nerve locating, mapping and the real-time assessment of neurophysiologic changes that may occur throughout the course of surgery. The result is an intuitive, surgeon-directed solution for objectively understanding how individual nerves are responding to surgery... prior to leaving the operating room.

INDICATIONS FOR USE

This device is intended for use in surgical procedures to assist in locating and mapping motor nerves through the use of mechanomyographic (MMG) signals and electrical stimulus of nerves. The device provides information directly to the surgeon to help assess a patient's neurophysiologic status by measuring and comparing MMG signals throughout a surgical procedure.

The device is intended to identify relative changes in the conduction and neural transmission ability of the nerve throughout a surgical procedure by measuring and comparing the minimum amount of electrical stimulation current (mA) required to induce a measurable MMG response (MMG nerve response threshold).

Examples of surgical applications which may require mechanomyographic (MMG) monitoring:

• Minimally invasive and open spinal surgery involving spinal fusion cages, screws, rods, plates, discs and biologics.

• Minimally invasive, open and endoscopic, direct and indirect nerve decompressions, discectomies, laminectomies, laminotomies, facetectomies, foraminotomies.

• Treatment of nerve compression, stenosis, degenerative disc disease, disc herniation, spondylolisthesis.

FDA cleared under K243636

† Wessell N, Khalil J, Zavatsky J, Ghacham W, Bartol S. Verification of nerve decompression using mechanomyography. Spine J. 2016 Jun;16(6):679-86. 

DECOMPRESSION ASSESSMENT - CASE REPORT

A 65-year-old female patient presented with severe low back pain, radiating pain to the left buttock, thigh and knee, and left knee extension weakness. Conservative treatment with epidural steroid injections and physical therapy was insufficient in treating her symptoms. MRI imaging showed a left far lateral disc herniation at L3–4. A MIS tubular far lateral discectomy was planned with the use of MMG. The skin incision was made 5 cm off the midline, overlying the L3–4 space. A 15 mm tubular retractor was placed between the transverse process and the pars. The soft tissue was dissected with the use of the microscope. After the identification of the transverse process, the lateral aspect of the facet joint, and the pars, the intertransverse ligament was incised and removed. The pedicle and exiting nerve root were identified. Prior to decompression, the MMG stimulus threshold was greater than 10 mA. After obtaining the stimulus threshold, the disc at L3–4 was incised, and the discectomy was performed. After the exiting nerve root was deemed adequately decompressed, the MMG stimulus threshold did not change. It was decided to further explore the disc space caudally, and an additional disc fragment was identified and removed. After removal, the MMG stimulus threshold decreased from greater than 10 mA to 3 mA. After surgery, the patient was observed for 3h in recovery and demonstrated adequate mobilization without pain. The patient was safely discharged home on the same day.‡ 

‡ Sommer F, Hussain I, Willett N, Hamad MK, Ikwuegbuenyi CA, Navarro-Ramirez R, Kirnaz S, McGrath L, Goldberg J, Ng A, Mykolajtchuk C, Haber S, Sullivan V, Gadjradj PS, Härtl R. Implementation and Feasibility of Mechanomyography in Minimally Invasive Spine Surgery. J Pers Med. 2025 Jan 23;15(2):42.

Neuralytix is a registered trademark of Neuralytix, LLC. 

Neuralytix technology is protected by US Patents 11,850,040; 11,850,057; 11,980,476; 11,980,474; 12,279,880; 12,279,879; 12,279,881.