Linked area parameter adjustment for spinal cord stimulation and associated systems and methods

• US 8,712,535 B2
• Filed: 06/10/2013
• Issued: 04/29/2014
• Est. Priority Date: 07/28/2009
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Walker, Andre B., Parker, Jon
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US13/914,494
• Publication Number:
  US 20140031893A1
• Time in Patent Office: 323 Days
• Field of Search: 607/2, 607/46, 607/116
• US Class Current: 607/46
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Systems and methods for managing pain in a patient using an electrical waveform that link the modulation of a waveform parameter for different areas of a patient. One embodiment in a system for managing pain in a patient comprises an electric device configured to be implanted into the patient and including a plurality of electrodes having at least a first electrode associated with a first area of the patient and a second electrode associated with a second area of the patient. The system further includes an implantable device configured to be coupled to the electrode device and having a computer-operable medium programmed to change the waveform parameter applied to the first electrode and automatically set the waveform parameter applied to the second electrode based on a relationship between a first therapy range and a second therapy range of the waveform parameter.

Claims

1. A method for programming an implantable patient treatment device, the patient treatment device including a power supply coupled to a waveform generator, the waveform generator being coupleable to an electrode device, the electrode device including a plurality of electrodes and being configured to be implanted into a patient, the method comprising:

programming the implantable treatment device with instructions that, when executed,

receive an indication of an association between (a) a first area of a patient and a first electrode of the electrode device and (b) a second area of the patient and a second electrode of the electrode device;

associate the first area with a first therapy range for a waveform parameter;

associate the second area with a second therapy range for the waveform parameter, wherein the therapy ranges are ranges of the waveform parameter that provide therapeutic effect without inducing discomfort;

change the waveform parameter applied to the first electrode; and

automatically set the waveform parameter applied to the second electrode based on a mathematical relationship between the first therapy range and the second therapy range.

2. The method of claim 1 wherein the mathematical relationship is a ratio of the first therapy range to the second therapy range.

3. A method for configuring an implantable patient treatment device, comprising:

programming the implantable treatment device with instructions that, when executed,

associate a first electrode of an implantable electrode device with a first area of a patient and with a first therapy range for a waveform parameter;

associate a second electrode of the implantable electrode device with a second area of the patient and with a second therapy range for the waveform parameter, wherein the therapy ranges are ranges of the waveform parameter that provide a therapeutic effect without inducing discomfort; and

in response to a requested change in the waveform applied to the first area or the first electrode, automatically set the waveform parameter applied to the second electrode based on a mathematical relationship between the first therapy range and the second therapy range.

4. The method of claim 3 wherein the relationship is a ratio of first therapy range to second therapy range.

5. The method of claim 3, further comprising programming the implantable treatment device with instructions that, when executed:

(a) change the waveform parameter applied to the first electrode by a first increment; and

(b) set the waveform parameter applied to the second electrode by a second increment in direct proportion to a ratio of the first therapy range to the second therapy range.

6. The method of claim 3, further comprising programming the implantable treatment device with instructions that, when executed:

(a) change the waveform parameter applied to the first electrode by a change increment for each of multiple change commands received by the implantable device; and

(b) set the waveform parameter applied to the second electrode according to a best-fit approximation of a ratio of the first therapy range to the second therapy range.

7. The method of claim 6, further comprising programming the implantable treatment device with instructions that, when executed, set the waveform parameter applied to the second electrode by changing the waveform parameter applied to the second electrode by the change increment or holding the waveform parameter applied to the second electrode constant for each of multiple change commands received by the implantable device.

8. The method of claim 3 wherein:

the waveform parameter comprises the power of the waveform, the first therapy range comprises a first power range between (a) a sensation threshold and/or a therapeutic threshold and (b) a discomfort threshold for the first area, and the second therapy range comprises a second power range between (a) a sensation threshold and/or a therapeutic threshold and (b) a discomfort threshold for the second area; and

wherein the method further comprises programming the implantable treatment device with instructions that when executed;

receive a change command; and

(a) change the power of the waveform applied to the first electrode by a first power increment; and

(b) set the power of the waveform applied to the second electrode by a second power increment in direct proportion to a ratio of the first power range to the second power range.

9. The method of claim 3, further comprising programming the patient treatment device with instructions that, when executed, determine a ratio of the first therapy range to the second therapy range based on a history of patient usage patterns.

10. The method of claim 3, further comprising programming the patient treatment device with instructions that, when executed:

determine that the first area of the patient is not linked to the second area of the patient,

change the first waveform parameter applied to the first electrode; and

set the second waveform parameter applied to the second electrode independently of the first waveform parameter applied to the first electrode.

11. The system of claim 3, further comprising programming the patient treatment device with instructions that, when executed,

change the waveform parameter applied to the first electrode and set the waveform parameter applied to the second electrode based on (a) a first ratio of the first therapy range to the second therapy range when the patient is in a first patient position or (b) a second ratio of the first therapy range to the second therapy range when the patient is in a second patient position.

12. The system of claim 3, further comprising programming the patient treatment device with instructions that, when executed, decouple control of the waveform parameter applied to the first and second electrodes when the waveform parameter exceeds a maximum value for one of the first or second electrodes.

13. A method for configuring an implantable patient treatment device, comprising:

programming the patient treatment device with instructions that, when executed;

change a level of a waveform parameter applied to a first electrode implanted at a first area of the patient, the first area being associated with a first therapy range; and

automatically set a level of the waveform parameter applied to a second electrode, located at second area of the patient and being associated with a second therapy range, based on a scaling factor relating the first therapy range to the second therapy range.

14. The method of claim 13 wherein the scaling factor is a ratio of the first therapy range to the second therapy range.

15. The method of claim 13 wherein the therapy ranges are ranges of the waveform parameter that provide a therapeutic effect without inducing discomfort.

16. The method of claim 13, further comprising programming the patient treatment device with instructions that, when executed:

change the waveform parameter applied to the first electrode by a first increment; and

change the waveform parameter applied to the second electrode by a second increment in direct proportion to a ratio of the first therapy range to the second therapy range.

17. The method of claim 13, further comprising programming the patient treatment device with instructions that, when executed, receive a plurality of change commands, and wherein:

the scaling factor is a ratio of the first therapy range to the second therapy range;

the waveform parameter applied to the first electrode is changed by a first increment for each change command input; and

for each change command input, the waveform parameter applied to the second electrode is set by (a) changing the waveform parameter applied to the second electrode by the first increment or (b) holding the waveform parameter applied to the second electrode constant.

18. The method of claim 13, further comprising programming the patient treatment device to prevent the waveform parameter applied to the first electrode from exceeding a first maximum and preventing the waveform parameter applied to the second electrode from exceeding a second maximum.

19. The method of claim 13 wherein the waveform parameter comprises waveform amplitude.

20. The method of claim 13 wherein the waveform parameter comprises impedance between a remote electrode and each of the first electrode at the first area and the second electrode at the second area.

21. The method of claim 13 wherein the waveform parameter comprises waveform power.

22. The method of claim 13 wherein:

the first therapy range corresponds to a difference between (a) a first sensation threshold and/or a first therapeutic threshold and (b) a first discomfort threshold for the first area; and

the second therapy range corresponds to a difference between (a) a second sensation threshold and/or a second therapeutic threshold and (b) a second discomfort threshold for the second area.

23. The method of claim 13, further comprising programming the patient treatment device to:

store diagnostics including a plurality of observed patient usage patterns; and

transmit the diagnostics of observed patient usage patterns to a remote processor that determines the first therapy range, the second therapy range, and a ratio of the first therapy range to the second therapy range.

24. The method of claim 13, further comprising programming the patient treatment device with instructions that, when executed:

determine a first ratio of the first therapy range to the second therapy range associated with a first patient position;

determine a second ratio of the first therapy range to the second therapy range associated with a second patient position; and

change the waveform parameter applied to the first and second electrodes based on the first ratio when the patient is in the first position or based on the second ratio when the patient is in the second position.

25. The method of claim 13, further comprising programming the patient treatment with instructions that, when executed:

receive a first maximum for the waveform parameter applied to the first electrode and set a second maximum for the waveform parameter applied to the second electrode; and

decouple the second electrode from the first electrode for adjustment of the parameter when one of the first or second electrodes has reached the first or second maximum, respectively.