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
First Claim
1. A system for treating pain in a patient using spinal cord stimulation, wherein (i) the pain includes a first pain component within a first bodily sub-region of a trunk of the patient, (ii) the pain includes a second pain component within a second bodily sub-region of lower extremities of the patient separated from the first bodily sub-region by intervening bodily sub-regions, the system comprising:
- a paddle structure adapted to be implanted within epidural space of the patient with the paddle structure having electrodes disposed in at least four mutually adjacent columns and at least two adjacent rows on the paddle structure;
a pulse generator that is electrically coupled to the paddle structure and that is programmable to deliver pulses to a spinal cord of the patient using the electrodes of the paddle structurea non-transient computer-readable medium with instructions stored thereon that, when executed, cause the pulse generator to;
(i) generate a first electrical field, created by stimulation pulses having a first set of stimulation parameters including one or more first active electrode to treat pain in the first bodily sub-region, the first set of stimulation parameters applied through the first active electrode, has restricted spatial resolution to stimulate a first set of one or more dorsal column fibers; and
(ii) generate a second electrical field, created by the stimulation pulses having a second set of stimulation parameters including one or more second active electrode to treat the pain in the second bodily sub-region, the second set of stimulation parameters applied through the second active electrode, has the restricted spatial resolution to stimulate a second set of one or more dorsal column fibers;
wherein, in response to the program, the patient experiences paresthesia in the first and second bodily sub-regions and the patient experiences minimal sensory effects from applied electrical pulses in the intervening bodily sub-regions.
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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.
11 Citations
15 Claims
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1. A system for treating pain in a patient using spinal cord stimulation, wherein (i) the pain includes a first pain component within a first bodily sub-region of a trunk of the patient, (ii) the pain includes a second pain component within a second bodily sub-region of lower extremities of the patient separated from the first bodily sub-region by intervening bodily sub-regions, the system comprising:
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a paddle structure adapted to be implanted within epidural space of the patient with the paddle structure having electrodes disposed in at least four mutually adjacent columns and at least two adjacent rows on the paddle structure; a pulse generator that is electrically coupled to the paddle structure and that is programmable to deliver pulses to a spinal cord of the patient using the electrodes of the paddle structure a non-transient computer-readable medium with instructions stored thereon that, when executed, cause the pulse generator to; (i) generate a first electrical field, created by stimulation pulses having a first set of stimulation parameters including one or more first active electrode to treat pain in the first bodily sub-region, the first set of stimulation parameters applied through the first active electrode, has restricted spatial resolution to stimulate a first set of one or more dorsal column fibers; and (ii) generate a second electrical field, created by the stimulation pulses having a second set of stimulation parameters including one or more second active electrode to treat the pain in the second bodily sub-region, the second set of stimulation parameters applied through the second active electrode, has the restricted spatial resolution to stimulate a second set of one or more dorsal column fibers; wherein, in response to the program, the patient experiences paresthesia in the first and second bodily sub-regions and the patient experiences minimal sensory effects from applied electrical pulses in the intervening bodily sub-regions. - View Dependent Claims (2, 3, 4, 5)
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6. A method of treating pain in a patient with spinal cord stimulation, wherein i) the pain includes at least two bodily sub-regions of the patient and the bodily sub-region of the patient comprises upper extremities, lower extremities or a trunk of the patient, ii) a paddle lead implanted within epidural space of the patient, the method comprising
selecting a set of stimulation parameters including at least one active electrode combination to treat the pain in the bodily sub-region, wherein the paddle lead comprises a plurality of electrodes disposed in at least four mutually adjacent columns and at least two adjacent rows on the paddle structure; - and
controlling a pulse generator to generate electrical pulses and to apply electrical pulses to the patient through the paddle lead according to the stimulation parameters, wherein; an electric field, created by stimulation pulses applied through the active electrode combination, has a restricted spatial resolution to stimulate one or more dorsal column fibers associated with the bodily sub-region without causing the stimulation of the dorsal column fibers associated with other bodily regions, wherein, in response to applied electrical pulses, the patient experiences paresthesia in the bodily sub-region with minimal sensory effects from the applied electrical pulses in other the bodily regions. - View Dependent Claims (7, 8, 9, 10, 11, 12)
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13. A method of treating pain in a patient using spinal cord stimulation, the method comprising:
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operating a programming device to control stimulation settings of a pulse generator, wherein (i) the pulse generator is electrically coupled to a stimulation paddle lead, (ii) the stimulation paddle lead is capable of being implanted within epidural space of the patient, the stimulation paddle lead comprises a structure having a plurality of electrodes disposed in at least four mutually adjacent columns and at least two adjacent rows on the structure; and selecting at least one active electrode combination to define a stimulation therapy for the patient, wherein application of electrical stimulation using the selected one active electrode combination applies paresthesia to at least two sub-regions of a bodily region of the patient and does not cause paresthesia outside of the sub-regions or in intervening sub-regions. - View Dependent Claims (14, 15)
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Specification