DEVICES FOR CONTROLLING HIGH FREQUENCY SPINAL CORD MODULATION FOR INHIBITING PAIN, AND ASSOCIATED SYSTEMS AND METHODS, INCLUDING SIMPLIFIED CONTACT SELECTION

• US 20100274317A1
• Filed: 04/22/2010
• Published: 10/28/2010
• Est. Priority Date: 04/22/2009
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Crg Servicing LLC
• Inventors: Thacker, James R., Parker, Jon
• Granted Patent: US 9,592,388 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• 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 1/06 for high-frequency therapy
• CPC Class Codes: A61N 1/323 Interference currents, i.e. treatment by several currents summed in the body
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36062 Spinal stimulation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36089 Addiction or withdrawal from substance abuse such as alcohol or drugs
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36157 Current A61N1/3616 takes precedence
• CPC Class Codes: A61N 1/3616 Voltage density or current density
• CPC Class Codes: A61N 1/36164 Sub-threshold or non-excitatory signals non-excitatory signals to the heart A61N1/3628
• CPC Class Codes: A61N 1/36167 Timing, e.g. stimulation onset
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/36175 Pulse width or duty cycle
• CPC Class Codes: A61N 1/36178 Burst or pulse train parameters
• CPC Class Codes: A61N 1/36182 Direction of the electrical field, e.g. with sleeve around stimulating electrode
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37241 : providing test stimulations
• CPC Class Codes: A61N 1/37247 : User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37264 : Changing the program; Upgrading firmware
• CPC Class Codes: A61N 1/3787 : from an external energy source
• CPC Class Codes: G01R 21/133 : by using digital technique

Abstract

Selective high-frequency spinal chord modulation for inhibiting pain with reduced side affects and associated systems and methods are disclosed. In particular embodiments, high-frequency modulation in the range of from about 1.5 KHz to about 50 KHz may be applied to the patient'"'"'s spinal chord region to address low back pain without creating unwanted sensory and/or motor side affects. In other embodiments, modulation in accordance with similar parameters can be applied to other spinal or peripheral locations to address other indications. In particular embodiments, aspects of the foregoing modulation therapies may be implemented by systems and devices that have simplified functionalities.

Claims

1-30. -30. (canceled)

31. A patient therapy system, comprising:

a patient-implantable signal delivery device that includes an elongated spinal cord lead body having multiple electrical contacts;

a pulse generator electrically connected to the signal delivery device, the pulse generator being programmed with instructions for delivering a modulation signal; and

a remote control operatively coupled to the pulse generator, the remote control having at least one input device to change characteristics of a modulation signal directed from the pulse generator to the signal delivery device, the characteristics including;

contacts to which the modulation signal is applied; and

an amplitude of the modulation signal, independent of which contacts the modulation signal is applied to, and wherein the remote control is incapable of changing the electrical contacts from anodic to cathodic or cathodic to anodic based on user input.

32. The system of claim 31 wherein a cathodic contact is an electrical contact that receives a negative, polarizing pulse at the outset of a pulse train in accordance with which the modulation signal is delivered.

33. The system of claim 31 wherein the pulse generator is programmed with instructions for delivering a modulation signal at a frequency of from about 3 kHz to about 50 kHz.

34. The system of claim 31 wherein the signal delivery device includes an elongated spinal cord lead body.

35. The system of claim 31 wherein the remote control is wirelessly coupled to the pulse generator.

36. The system of claim 31 wherein the remote control is coupled to the pulse generator with a releasable wired link.

37. The system of claim 31 wherein the pulse generator includes instructions for automatically establishing which contact is anodic and which is cathodic.

38. The system of claim 31 wherein the pulse generator is carried by the remote control.

39. The system of claim 31 wherein the pulse generator is a patient-implantable pulse generator.

40. A patient therapy system, comprising:

a patient-implantable signal delivery device that includes an elongated spinal cord lead body having multiple electrical contacts;

a pulse generator electrically connected to the signal delivery device, the pulse generator being programmed with instructions for delivering a modulation signal; and

a remote control operatively coupled to the pulse generator, the remote control having at least one input device to change characteristics of a modulation signal directed from the pulse generator to the signal delivery device, the characteristics including;

contacts to which the modulation signal is applied; and

an amplitude of the modulation signal, independent of which contacts the modulation signal is applied to, and wherein at least one of the remote control and the pulse generator automatically designates electrical contacts as anodic or cathodic without user input.

41. The system of claim 40 wherein a cathodic contact is an electrical contact that receives a negative, polarizing pulse at the outset of a pulse train in accordance with which the modulation signal is delivered.

42. The system of claim 40 wherein the pulse generator is carried by the remote control.

43. The system of claim 40 wherein the pulse generator is a patient-implantable pulse generator.

44. A method for operating a patient therapy system, comprising:

controlling a pulse generator coupled to an implanted spinal cord signal delivery device having multiple implanted electrical contacts, via a remote control positioned external to the patient, by selecting a pair of active contacts, wherein selecting a pair of active contacts includes selecting the pair of active contacts without specifying which contact is anodic and which contact is cathodic.

45. The method of claim 44 wherein a cathodic electrical contact is an electrical contact that receives a negative, polarizing pulse at the outset of a pulse train in accordance with which the modulation signal is delivered, and wherein the method further comprises activating the active contacts without specifying which contact is anodic and which contact is cathodic.

46. The method of claim 44, further comprising implanting the signal delivery device proximate to the patient'"'"'s spine, within a foramen of at least one of the patient'"'"'s vertebra.

47. The method of claim 44 wherein controlling a pulse generator includes controlling a pulse generator delivering a modulation signal at a frequency of from about 3 kHz to about 50 kHz.

48. The method of claim 44 wherein controlling a pulse generator includes controlling a pulse generator that is external to the patient.

49. The method of claim 44 wherein controlling a pulse generator includes controlling a pulse generator that is implanted in the patient.

50. A computer-implemented method for controlling modulation signals applied to a patient'"'"'s spinal cord, comprising:

receiving a user input corresponding to a target location at the patient'"'"'s spinal cord;

based at least in part on the input received, automatically selecting a pair of electrical contacts; and

automatically delivering a modulation signal to the pair of electrical contacts at a frequency of from about 3 kHz to about 50 kHz, without or independent of any user input corresponding to a designation of at least one of the contacts as an anode or a cathode.

51. The method of claim 50 wherein automatically selecting a pair of electrical contacts includes automatically selecting a pair of contacts of an elongated spinal cord lead.

52. The method of claim 50 wherein the user input is a first user input, and wherein the method further comprises receiving a second user input corresponding to a target amplitude of the modulation signal.

53. The method of claim 50 wherein receiving the user input includes receiving the user input via an input device that is coupled to a pulse generator.

54. The method of claim 50 wherein receiving the user input includes receiving the user input via a remote input device that is wirelessly coupled to an implanted pulse generator.

55. The method of claim 50, further comprising presenting a representative pain score correlated with at least one of a modulation location and a modulation amplitude.

56-82. -82. (canceled)