Techniques for Positioning Therapy Delivery Elements within a Spinal Cord or Brain

• US 20100241179A1
• Filed: 06/04/2010
• Published: 09/23/2010
• Est. Priority Date: 04/30/1998
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Petersen, Daryle, Rise, Mark T., King, Gary W., Schendel, Michael, Starkebaum, Warren, Gielen, Frans
• Granted Patent: US 8,600,495 B2
• Time in Patent Office: Days
• US Class Current: 607/2
• 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 plurality of leads, each lead connected to an implanted paddle lead, the implanted paddle lead having a plurality of therapy delivery elements, the paddle lead positioned in close proximity to a target site of a patient;

a plurality of threaded collars adapted to be screwed into bone of a patient, each threaded collar defining a proximal opening in a top portion of the threaded collar, a passageway through the threaded collar, and a distal opening, wherein the proximal opening, passageway and distal opening are adapted to allow a corresponding lead to be inserted therethrough and be disposed in close proximity to the distal opening of the threaded collar.

2. The medical device according to claim 1, wherein at least one therapy delivery element is an electrode.

3. The medical device according to claim 1, wherein at least one lead is a catheter and at least one therapy delivery element defines a drug infusion opening.

4. The medical device according to claim 1, further comprising a means for positioning at least one therapy delivery element closer to a target site of a patient.

5. The medical device according to claim 1, wherein at least one threaded collar comprises a threaded inner housing, wherein at least one threaded inner housing defines the distal opening, the passageway, and the proximal opening adapted to allow a lead to be inserted therethrough and be disposed in close proximity to the distal opening.

6. The medical device according to claim 5, wherein the top portion of at least one threaded inner housing comprises a cavity adapted to be turned by a screwdriver-like device.

7. The medical device according to claim 5, wherein the top portion of at least one threaded inner housing comprises a cavity adapted to be turned by a slotted screwdriver-like device.

8. The medical device according to claim 5, wherein the top portion of at least one threaded inner housing comprises a hexagonal cavity adapted to be turned by a hexagonal wrench-like device.

9. The medical device according to claim 5, wherein the top portion of at least one threaded inner housing comprises a hexagonal cavity adapted to be turned by a percutaneous needle.

10. The medical device according to claim 5, further comprising a means for positioning at least one therapy delivery element closer to a target site of a patient.

11. The medical device according to claim 5, further comprising a swivel mechanism to allow turning of the threaded inner housing but not the corresponding lead.

12. The medical device according to claim 5, further comprising a ball and socket to allow turning of the threaded inner housing but not the corresponding lead.

13. The medical device according to claim 5, wherein at least one therapy delivery element is an electrode.

14. 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 burr hole ring adapted to be inserted into an opening in a skull of a patient;

a threaded collar adapted to be screwed into the burr hole ring, the threaded collar defining a proximal opening in a top portion of the threaded collar, a passageway through the threaded collar, and a distal opening, wherein the proximal opening, passageway and distal opening are adapted to allow the therapy delivery element to be inserted therethrough and be disposed in close proximity to the distal opening of the threaded collar.

15. The medical device of claim 14, wherein the therapy delivery element is an electrode.

16. The medical device of claim 14, wherein the lead is a catheter and the therapy delivery element defines a drug infusion opening.

17. The medical device of claim 14 further comprising a grid of a plurality of therapy delivery elements.

18. 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 threaded collar adapted to be screwed into bone of a patient, the threaded collar defining a proximal opening in a top portion of the threaded collar, a passageway through the threaded collar, and a distal opening, wherein the proximal opening, passageway and distal opening are adapted to allow the electrode to be inserted therethrough and be disposed in close proximity to the distal opening of the threaded collar.

19. The system according to claim 18, wherein the threaded collar comprises a threaded inner housing, wherein the threaded inner housing defines the distal opening, the passageway, and the proximal opening adapted to allow the electrode to be inserted therethrough and be disposed in close proximity to the distal opening.

20. The system according to claim 18, wherein the threaded collar comprises an inner housing having an O ring to hold the inner housing in position within the threaded collar, wherein the inner housing defines the distal opening, the passageway, and the proximal opening adapted to allow the electrode to be inserted therethrough and be disposed in close proximity to the distal opening.