Techniques for positioning therapy delivery elements within a spinal cord or brain

• US 20070123954A1
• Filed: 01/31/2007
• Published: 05/31/2007
• Est. Priority Date: 04/30/1998
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: King, Gary, Schendel, Michael, Starkebaum, Warren, Gielen, Frans, Petersen, Daryle, Rise, Mark
• Granted Patent: US 7,734,342 B2
• Time in Patent Office: Days
• US Class Current: 607/51
• CPC Class Codes: A61M 2209/045 for filling, e.g. for filling reservoirs
• CPC Class Codes: A61M 2210/0693 Brain, cerebrum
• CPC Class Codes: A61M 2210/1003 Spinal column
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/36071 Pain

Abstract

Apparatus and techniques to address problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are 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, such as electrical stimulation and/or drug infusion to a precise target. 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 maybe 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.

Claims

1. A medical device for providing therapy to a body comprising:

a lead having at least one therapy delivery element at a distal end of the lead;

a housing adapted so that at least a portion of the housing can be inserted into bone of a patient, the housing defining a proximal opening in a top portion of the housing, a passageway through the housing, and a distal opening, the proximal opening and passageway adapted to allow the therapy delivery element to be inserted therethrough and be positioned closer to the distal opening than the proximal opening.

2. The medical device according to claim 1, wherein the top portion of the housing is adapted to be turned by a screwdriver-like device.

3. The medical device according to claim 1, wherein the top portion of the housing comprises a cavity adapted to be turned by a slotted screwdriver-like device.

4. The medical device according to claim 1, wherein the top portion of the housing comprises a cavity adapted to be turned by a wrench-like device or percutaneous needle.

5. The medical device according to claim 1, wherein the therapy delivery element is an electrode.

6. The medical device according to claim 1, wherein the lead is a catheter and the therapy delivery element defines a drug infusion portion.

7. The medical device according to claim 1, further comprising a collar, wherein the collar is adapted to be screwed into the bone of the patient, wherein at least a portion of the housing is inserted into a channel defined by the collar.

8. The medical device according to claim 7, wherein the top portion of the housing is adapted to be turned by a screwdriver-like device.

9. The medical device according to claim 7, wherein the top portion of the housing comprises a cavity adapted to be turned by a slotted screwdriver-like device.

10. The medical device according to claim 7, wherein the top portion of the housing comprises a cavity adapted to be turned by a wrench-like device or percutaneous needle.

11. The medical device according to claim 7, wherein the therapy delivery element is an electrode.

12. The medical device according to claim 7, wherein the lead is a catheter and the therapy delivery element defines a drug infusion portion.

13. The medical device according to claim 7, wherein the collar comprises a ring to hold the housing in position within the collar.

14. The medical device according to claim 7, wherein the collar comprises locking means to hold the housing in position within the collar.

15. The medical device according to claim 7 comprising a plurality of leads and corresponding housings and collars.

16. The medical device according to claim 15, further comprising a swivel mechanism to allow turning of a housing but not a corresponding lead.

17. The medical device according to claim 15, in the further comprising a ball and socket to allow turning of a housing but not the corresponding lead.

18. The medical device according to claim 1, further comprising an anchor adapted attach to bone and to the lead, thereby fixing the position of the therapy delivery element at a target site of a patient.

19. The medical device according to claim 8, wherein the housing is a threaded screw and the collar comprises a burr hole ring.

20. A system for providing neurostimulation therapy to targeted tissue comprising in combination:

a signal generator;

a lead having at least one electrode at a distal end of the lead, the electrode electrically coupled to the signal generator;

a housing adapted so that at least a portion of the housing can be inserted into bone of a patient, the housing defining a proximal opening in a top portion of the housing, a passageway through the housing, and a distal opening, the proximal opening and passageway adapted to allow the electrode to be inserted therethrough and be positioned closer to the distal opening than the proximal opening.

21. A method for providing treatment therapy to targeted tissue comprising the steps of:

(a) implanting a therapy delivery device in a patient;

(b) implanting a collar into bone of a patient;

(c) inserting a housing into the collar, the housing defining a proximal opening in a top portion of the housing, a passageway through the housing, and a distal opening;

(d) implanting a lead in the patient through the proximal opening and passageway of the housing so that a therapy delivery element of the implanted lead lies closer to the distal opening than the proximal opening;

(e) coupling a proximal end of the lead to the implanted therapy delivery device; and

(f) operating the implanted therapy delivery device to provide treatment therapy to the targeted tissue via the therapy delivery element.

22. The method of claim 21, wherein the therapy delivery device comprises a signal generator and the therapy delivery element comprises an electrode.

23. The method as claimed in claim 21, wherein the therapy delivery device comprises a pump and the therapy delivery element comprises a drug infusion portion.