METHOD OF NEUROSTIMULATION OF DISTINCT NEURAL STRUCTURES USING SINGLE PADDLE LEAD TO TREAT MULTIPLE PAIN LOCATIONS AND MULTI-COLUMN, MULTI-ROW PADDLE LEAD FOR SUCH NEUROSTIMULATION

• US 20070179579A1
• Filed: 01/26/2007
• Published: 08/02/2007
• Est. Priority Date: 01/26/2006
• Status: Active Grant

• Current Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories)
• Original Assignee: Advanced Neuromodulation Systems Incorporated (Abbott Laboratories)
• Inventors: Erickson, John, FELER, Claudio
• Granted Patent: US 7,979,131 B2
• Time in Patent Office: Days
• US Class Current: 607/117
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration

Abstract

In some embodiments, a paddle lead is implanted within a patient such that the electrodes are positioned within the cervical or thoracic spinal levels. An electrode combination on a first row of electrodes can be determined that is effective for a first pain location with minimal effects on other regions of the body. The first pain location can be addressed by stimulating a first dorsal column fiber due to the relatively fine electrical field resolution achievable by the multiple columns. Then, another electrode combination on a second row of electrodes can be determined for a second pain location with minimal effects on other regions. The second pain location could be addressed by stimulating a second dorsal column fiber. After the determination of the appropriate electrodes for stimulation, the patient'"'"'s IPG can be programmed to deliver pulses using the first and second rows according to the determined electrode combinations.

Claims

1. A method of electrically neurostimulating a patient using a paddle lead, wherein the paddle lead is positioned within the epidural space of the patient and comprises at least five columns and multiple rows of electrodes;

stimulating a first dorsal column fiber of the patient using one or several electrodes on a first row of the paddle lead;

anodally blocking stimulation of at least one neural structure adjacent to the first dorsal column fiber using one or several electrodes on the first row of the paddle lead;

stimulating a second dorsal column fiber using one or several electrodes on a second row of the paddle lead; and

anodally blocking stimulation of at least one neural structure adjacent to the second dorsal column fiber using one or several electrodes on the second row of the paddle lead;

wherein stimulation of the first and second dorsal column fibers is provided to address pain in distinct regions of the patient'"'"'s body in a substantially concurrent basis.

2. The method of claim 1 further comprising:

hyperpolarizing at least one neural structure using one or several electrodes of the paddle lead.

3. The method of claim 1 wherein one of the distinct regions is associated with the lower extremities of the patient.

4. The method of claim 3 wherein the electrodes of the paddle lead are positioned within one or several thoracic segments of the patient'"'"'s spine.

5. The method of claim 3 wherein the electrodes of the paddle lead are positioned within one or several cervical segments of the patient'"'"'s spine.

6. The method of claim 1 wherein one of the distinct regions of the patient is the back of the patient.

7. The method of claim 6 wherein stimulating of the dorsal column fiber associated with the back of the patient addresses post-laminectomy pain.

8. The method of claim 1 wherein the paddle lead comprises a paddle having main electrodes with each main electrode having one or several encircling electrodes for anodally blocking an electrical field created by the main electrode when the main electrode is set as a cathode.

9. The method of claim 8 wherein each encircling electrode of the paddle lead is coupled to a common conductor within a lead body of the paddle lead.

10. The method of claim 1 wherein the paddle lead comprises sixteen electrodes.

11. The method of claim 1 wherein the paddle lead comprises thirty-two electrodes.

12. The method of claim 1 wherein the paddle lead comprises sixty-four electrodes.

13. The method of claim 1 wherein the first and second rows are separated by one or several rows of electrodes that are set to a high impedance state.

14. The method of claim 1 wherein the pain addressed by stimulation using at least one row of electrodes is associated with complex regional pain syndrome (CRPS) 1.

15. A system for electrically neurostimulating a patient, comprising:

a paddle lead that is positioned within the epidural space of the patient and comprises at least five columns and multiple rows of electrodes; and

a pulse generator that is electrically coupled to the paddle lead and that is programmable to deliver pulses to neural tissue of the patient using the electrodes of the paddle lead, wherein the pulse generator is programmed to;

(i) stimulate a first dorsal column fiber of the patient using one or several electrodes on a first row of the paddle lead;

(ii) anodally block stimulation of at least one neural structure adjacent to the first dorsal column fiber using one or several electrodes on the first row of the paddle lead;

(iii) stimulate a second dorsal column fiber using one or several electrodes on a second row of the paddle lead; and

(iv) anodally block stimulation of at least one neural structure adjacent to the second dorsal column fiber using one or several electrodes on the second row of the paddle lead;

wherein stimulation of the first and second dorsal column fibers addresses pain in distinct regions of the patient'"'"'s body in a substantially concurrent basis.

16. The system of claim 15 wherein the pulse generator is further programmed to hyperpolarize at least one neural structure using one or several electrodes of the paddle lead.

17. The system of claim 15 wherein one of the distinct regions is associated with the lower extremities of the patient.

18. The system of claim 17 wherein the electrodes of the paddle lead are positioned within one or several cervical segments of the patient'"'"'s spine.

19. A stimulation lead for electrically neurostimulating a patient, comprising:

a rigid paddle structure;

a plurality of electrodes disposed on the paddle structure, wherein the plurality of electrodes are mutually separated by insulative material, wherein the plurality of electrodes comprise at least five columns of electrodes disposed laterally along the paddle structure;

a lead body of insulative material coupled to the paddle structure at a distal end of the lead body;

a plurality of wire conductors encapsulated within the insulative material of the lead body;

a plurality of terminals on a proximal end of the lead body, wherein the plurality of terminals are electrically coupled to the plurality of electrodes through the plurality of wire conductors.

20. The stimulation lead of claim 19 wherein the paddle structure is adapted for implantation in the epidural space within one or several cervical segments of a patient, and wherein the electrodes in the at least five columns are separated longitudinally by 1.5 mm.