Identifying an area for electrical stimulation to treat a patient

• US 8,781,592 B2
• Filed: 09/07/2011
• Issued: 07/15/2014
• Est. Priority Date: 09/07/2011
• Status: Active Grant

• Current Assignee: Cirtec Medical Corp.
• Original Assignee: Greatbatch Limited (Greatbatch Incorporated)
• Inventors: Polefko, Richard J., Wilder, Steven E., Leyh, Scott G.
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US13/226,897
• Publication Number:
  US 20130060299A1
• Time in Patent Office: 1,042 Days
• Field of Search: 607/46, 607/59
• US Class Current: 607/46
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

A stimulation system, such as a spinal cord stimulation (SCS) system, having a programmer for identifying an area for electrical stimulation to treat a patient. The programmer includes a communication interface, a display screen, and a user interface. The communication interface communicates with the electrical stimulation generator to generate electrical stimulation and the display screen displays a patient model. The user interface receives user input identifying an area of pain on the patient model via a selection of the area of the body part. The programmer then associates the area of pain identified with a spinal column location, and displays on the display screen a suggested medical lead position and/or a suggested stimulation area on an image of a spinal column based on the step of associating.

Claims

1. A method of identifying an area for electrical stimulation with a stimulation system for treating a patient, the stimulation system comprising a programmer configured to communicate with an electrical stimulation generator, the method comprising:

displaying a patient model on a display screen of the programmer;

receiving, by the programmer, user input identifying an area of pain on the patient model via a selection of an area of a body part;

associating the area of pain identified with a spinal column location;

displaying on the display screen a suggested medical lead position and a suggested stimulation area, both on an image of a spinal column, based on the step of associating;

receiving, by the programmer, positioning input that indicates a position of a medical lead implanted in the patient with respect to the spinal column;

displaying a representation of the medical lead on the image of the spinal column in an anatomically correct location, in an actual orientation, and with an anatomically correct size, based on the positioning input;

determining an expected stimulation field based on the positioning input and stimulation parameters;

displaying the expected stimulation field on the image of the spinal column;

receiving graphical manipulations, via a graphical user interface, of one of a graphical boundary and graphical position of the expected stimulation field;

driving the medical lead with the electrical stimulation generator to generate electrical stimulation according to the expected stimulation field as manipulated;

generating electrical stimulation using the programmer, the electrical stimulation generator, and the medical lead at a first series of discrete locations, wherein the first series of discrete locations at least partially overlaps the suggested stimulation area, wherein each of the first series of locations is adjacent at least one of the other first series of locations, and wherein electrical stimulation is applied consecutively to adjacent locations of the first series of discrete locations; and

receiving patient feedback indicating the efficacy of the electrical stimulation for each location of the first series of discrete locations.

2. The method of claim 1, wherein displaying the suggested stimulation area further includes displaying a target area within the stimulation area.

3. The method of claim 1, further comprising,

generating electrical stimulation, with the programmer, the electrical stimulation generator, and the medical lead, at a second series of discrete locations, consecutively, wherein the second series of discrete locations is within a subset of the first series of discrete locations;

receiving additional patient feedback indicating the efficacy of the electrical stimulation for each location of the second series of discrete locations; and

identifying a subset of the second set of discrete locations for targeted electrical stimulation based on the additional patient feedback.

4. The method of claim 3, further comprising, generating electrical stimulation, with the programmer, the electrical stimulation generator, and the medical lead, at the identified subset of the second set of discrete locations.

5. A stimulation system for identifying an area for electrical stimulation to treat a patient, the stimulation system comprising:

an electrical stimulation generator;

a medical lead coupled to the electrical stimulation generator; and

a programmer including

a communication interface configured to communicate with the electrical stimulation generator to generate electrical stimulation,

a display screen, wherein the programmer is configured to instruct the display screen to display a patient model, and

a user interface configured to receive user input identifying an area of pain on the patient model via a selection of an area of a body part;

wherein

the programmer is further configured to associate the area of pain identified with a spinal column location and to instruct the display screen to display a suggested medical lead position and a suggested stimulation area, both on an image of a spinal column, based on the step of associating,

the user interface is further configured to receive positioning input that indicates a position of a medical lead implanted in the patient with respect to the spinal column,

the programmer is further configured to

instruct the display screen to display a representation of the medical lead on the image of the spinal column in an anatomically correct location, in an actual orientation, and with an anatomically correct size, based on the positioning input,

determine an expected stimulation field based on the positioning input and stimulation parameters,

instruct the display screen to display the expected stimulation field on the image of the spinal column,

the user interface is a graphical user interface and is further configured to receive graphical manipulations of one of a graphical boundary and graphical position of the expected stimulation field,

the electrical stimulation generator is configured to drive the medical lead to generate electrical stimulation according to the expected stimulation field as manipulated;

the electrical stimulation generator is further configured to drive the medical lead to generate electrical stimulation at a first series of discrete locations, wherein the first series of discrete locations at least partially overlaps the suggested stimulation area, wherein each of the first series of locations is adjacent at least one of the other first series of locations, and wherein electrical stimulation is applied consecutively to adjacent locations of the first series of discrete locations; and

the user interface is further configured to receive patient feedback indicating the efficacy of the electrical stimulation for each location of the first series of discrete locations.

6. The stimulation system of claim 5, wherein the programmer is further configured to instruct the display screen to display a target area within the stimulation area.

7. The stimulation system of claim 5, wherein

the electrical stimulation generator is further configured to drive the medical lead to generate electrical stimulation at a second series of discrete locations, consecutively, wherein the second series of discrete locations is within a subset of the first series of discrete locations;

the user interface is further configured to receive additional patient feedback indicating the efficacy of the electrical stimulation for each location of the second series of discrete locations; and

the programmer is further configured to identify a subset of the second set of discrete locations for targeted electrical stimulation based on the additional patient feedback.

8. The stimulation system of claim 7, wherein the electrical stimulation generator is further configured to drive the medical lead to generate electrical stimulation at the identified subset of the second set of discrete locations.

9. A programmer of a stimulation system used to identify an area for electrical stimulation to treat a patient, the stimulation system including an electrical stimulation generator and a medical lead coupled to the electrical stimulation generator, the programmer comprising:

a communication interface configured to communicate with the electrical stimulation generator to generate electrical stimulation,

a display screen, wherein the programmer is configured to instruct the display screen to display a patient model, and

a user interface configured to receive user input identifying an area of pain on the patient model via a selection of an area of a body part;

wherein

the programmer is further configured to associate the area of pain identified with a tissue location and to instruct the display screen to display a suggested medical lead position and a suggested stimulation area, both on an image of a tissue, based on the step of associating,

the user interface further is configured to receive positioning input that indicates a position of a medical lead implanted in the patient with respect to the tissue,

the programmer is further configured to

instruct the display screen to display a representation of the medical lead on the image of the tissue in an anatomically correct location, in an actual orientation, and with an anatomically correct size, based on the positioning input,

determine an expected stimulation field based on the positioning input and stimulation parameters,

instruct the display screen to display the expected stimulation field on the image of the tissue,

the user interface is a graphical user interface and is further configured to receive graphical manipulations of one of a graphical boundary and graphical position of the expected stimulation field,

the electrical stimulation generator is configured to drive the medical lead to generate electrical stimulation according to the expected stimulation field as manipulated;

the electrical stimulation generator is further configured to drive the medical lead to generate electrical stimulation at a first series of discrete locations, wherein the first series of discrete locations at least partially overlaps the suggested stimulation area, wherein each of the first series of locations is adjacent at least one of the other first series of locations, and wherein electrical stimulation is applied consecutively to adjacent locations of the first series of discrete locations; and

the user interface is further configured to receive patient feedback indicating the efficacy of the electrical stimulation for each location of the first series of discrete locations.

10. The programmer of claim 9 wherein the tissue is a spinal column.