Techniques for positioning therapy delivery elements within a spinal cord or a brain
First Claim
1. A method for providing treatment therapy to a targeted tissue by means of a therapy delivery device and at least one therapy delivery element coupled to the therapy delivery device, the method comprising the steps of:
- (a) implanting at least one lead having at least one therapy delivery element so that the therapy delivery element lies in communication near the targeted tissue;
(b) coupling a proximal end of the lead to the therapy delivery device;
(c) operating the therapy delivery device to provide treatment therapy to the targeted tissue via the implanted therapy delivery element; and
(d) adjusting, at any time after the step of implanting, the position of at least one implanted therapy delivery element relative to the targeted tissue.
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Abstract
The present invention addresses the problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. The present invention discloses techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment therapy. The present invention also discloses techniques for non-invasively positioning and re-positioning therapy delivery elements after implant to provide electrical stimulation and/or drug infusion to a precise target. A position control mechanism and/or a position controller are provided for adjusting in situ the position of the therapy delivery elements relative to the targeted tissue of interest. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system may be provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.
254 Citations
53 Claims
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1. A method for providing treatment therapy to a targeted tissue by means of a therapy delivery device and at least one therapy delivery element coupled to the therapy delivery device, the method comprising the steps of:
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(a) implanting at least one lead having at least one therapy delivery element so that the therapy delivery element lies in communication near the targeted tissue;
(b) coupling a proximal end of the lead to the therapy delivery device;
(c) operating the therapy delivery device to provide treatment therapy to the targeted tissue via the implanted therapy delivery element; and
(d) adjusting, at any time after the step of implanting, the position of at least one implanted therapy delivery element relative to the targeted tissue. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A system for providing treatment therapy to targeted tissue comprising in combination:
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(a) a therapy delivery device;
(b) at least one therapy delivery element coupled to the therapy delivery device for providing treatment therapy to the targeted tissue; and
(c) at least one position control mechanism coupled to at least one of the therapy delivery elements for adjusting, at any time after implanting the therapy delivery elements, the position of the therapy delivery element relative to the targeted tissue. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. An implantable lead for providing therapy to a body comprising:
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(a) an elongate central portion;
(b) at least one extendable member having an end, the extendable member depending from the central portion and being adapted to assume a compact position, in which the end is disposed in close proximity to the central portion, and an extended position, in which the extendable member is disposed at an angle laterally from the central portion; and
(c) at least one therapy delivery element disposed on the extendable member for delivering therapy to the body. - View Dependent Claims (34, 35, 36, 37)
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38. An implantable lead for providing therapy to a body comprising:
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(a) an elongate central portion; and
(b) at least one extendable member having an end, the extendable member depending from the central portion and being adapted to assume a compact position, in which the end is disposed in close proximity to the central portion, and an extended position, in which the end is disposed at a location distal from the central portion;
(c) at least one therapy delivery element disposed on the extendable member for delivering therapy to the body;
(d) a lever coupled near the end of the extendable member and the central portion capable of selectively adjusting the direction of extension of the extendable member relative to the central portion. - View Dependent Claims (39, 40)
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41. A system for providing neurostimulation therapy to targeted tissue comprising in combination:
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(a) a signal generator;
(b) at least one housing member implantable within a bone near the targeted tissue and adjustable relative to the bone; and
(c) at least one electrode coupled to said signal generator and attached to a distal end of the housing member for providing electrical stimulation to the targeted tissue. - View Dependent Claims (42)
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43. An implantable paddle-like lead for providing treatment therapy to targeted tissue of a body comprising:
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(a) a middle portion having at least one central therapy delivery element on a ventral side;
(b) at least two end portions, each end portion having at least one end therapy delivery element on the ventral side; and
(c) a fluid reservoir portion along the middle portion capable of receiving fluid and expanding the middle portion such that the central therapy delivery element is positioned away from a dorsal side of the lead.
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44. An implantable paddle-like lead for providing treatment therapy to targeted tissue of a body comprising:
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(a) a middle portion having at least one central therapy delivery element on a ventral side;
(b) at least two end portions, each end portion having at least one end therapy delivery element on the ventral side; and
(c) a piston coupling the front side and a back side of the lead capable of expanding the middle portion such that the central therapy delivery element is positioned away from a dorsal side of the lead.
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45. An implantable paddle-like lead for providing treatment therapy to targeted tissue of a body comprising:
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(a) a middle portion having at least one central therapy delivery element on a ventral side;
(b) at least two end portions, each end portion having at least one end therapy delivery element on the ventral side; and
(c) at least one bellows coupling the front side and a back side of the lead capable of expanding the middle portion such that the central therapy delivery element is positioned away from a dorsal side of the lead.
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46. An implantable paddle-like lead for providing treatment therapy to targeted tissue of a body comprising:
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(a) a ventral side having at least one therapy delivery elements;
(b) a dorsal side opposite the front side;
(c) at least one balloon-like member attached to the back side of the lead, the balloon-like member capable of expanding by receiving a fluid, whereby expansion of the balloon-like member resulting in positioning at least one of the therapy delivery elements closer to or further from the targeted tissue. - View Dependent Claims (47, 48)
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49. An implantable paddle-like lead for providing treatment therapy to targeted tissue of a body comprising:
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(a) a ventral side having at least one therapy delivery elements;
(b) at least one glider mechanism attached to the ventral side of the lead capable of movement; and
(c) a membrane covering the glider means, whereby movement of the glider mechanism results in lead expansion and positioning of at least one of the therapy delivery elements closer to or further from the targeted tissue.
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50. An implantable paddle-like lead for providing treatment therapy to targeted tissue of a body comprising:
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(a) a ventral side having at least one therapy delivery elements;
(b) at least one flexible wire means attached to the ventral side of the lead capable of flexing; and
(c) a membrane covering the flexible wire means, whereby flexing of the flexible wire means results in lead expansion and positioning of at least one of the therapy delivery elements closer to or further from the targeted tissue.
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51. An implantable paddle-like lead for providing treatment therapy to targeted tissue of a body comprising:
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(a) a ventral side having at least one therapy delivery elements;
(b) at least one gear mechanism attached to the lead capable of rotating; and
(e) at least one arm coupled to the gear;
whereby rotation of at least one arm results in lead expansion and positioning of at least one of the therapy delivery elements closer to or further from the targeted tissue.
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52. A method for providing treatment therapy to a targeted neural tissue by means of a therapy delivery device and at least one therapy delivery element coupled to the therapy delivery device, the method comprising the steps of:
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(a) implanting at least one lead having at least one therapy delivery element within a bone so that the therapy delivery element lies within the bone and in communication near a the targeted tissue;
(b) coupling a proximal end of the lead to the therapy delivery device; and
(c) operating the therapy delivery device to provide treatment therapy to the targeted tissue via the implanted therapy delivery element. - View Dependent Claims (53)
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Specification