Methods for stimulating a dorsal root ganglion

• US 9,205,260 B2
• Filed: 07/16/2012
• Issued: 12/08/2015
• Est. Priority Date: 09/08/2004
• Status: Active Grant

• Current Assignee: TC1 LLC (Abbott Laboratories), Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Original Assignee: Spinal Modulation, Inc. (Abbott Laboratories), Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Kim, Daniel H., Imran, Mir A.
• Primary Examiner(s): Bosques, Edelmira
• Application Number:
  US13/550,439
• Publication Number:
  US 20120283697A1
• Time in Patent Office: 1,240 Days
• Field of Search: 604/890.1, 604/891.1, 604/93.01, 604/131
• US Class Current: 1/1
• CPC Class Codes: A61M 2210/1003 Spinal column
• CPC Class Codes: A61M 25/06 Body-piercing guide needles or the like
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/0568 with drug delivery
• 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 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36171 Frequency

Abstract

Some embodiments of the present invention provide stimulation systems and components for selective stimulation and/or neuromodulation of one or more dorsal root ganglia through implantation of an electrode on, in or around a dorsal root ganglia. Some other embodiments of the present invention provide methods for selective neurostimulation of one or more dorsal root ganglia as well as techniques for applying neurostimulation to the spinal cord. Still other embodiments of the present invention provide stimulation systems and components for selective stimulation and/or neuromodulation of one or more dorsal root ganglia through implantation of an electrode on, in or around a dorsal root ganglia in combination with a pharmacological agent.

Claims

1. A method of pharmacologically modulating a dorsal root ganglion comprising:

implanting an elongate body into an epidural space, wherein the elongate body has a conduit for delivery of a pharmacological agent;

advancing the elongate body along a nerve root and positioning an outlet of the conduit near the dorsal root ganglion associated with the nerve root; and

delivering a pharmacological agent from an implanted delivery device through the conduit so that the pharmacological agent pharmacologically modulates the dorsal root ganglion without pharmacologically modulating an associated ventral root, wherein the implanted delivery device comprises a reservoir for storing the pharmacological agent and a pump for moving the pharmacological agent from the reservoir to the conduit.

2. The method as in claim 1, wherein the pharmacological agent modulates the dorsal root ganglion by acting upon at least one cell body within the dorsal root ganglion.

3. The method as in claim 1, wherein the pharmacological agent modifies electrophysiological excitability of the dorsal root ganglion.

4. The method as in claim 3, wherein the electrophysiological excitability of the dorsal root ganglion is decreased at least in part by reducing the extent of membrane depolarization.

5. The method as in claim 1, wherein the pharmacological agent comprises a pharmacological blocker.

6. The method as in claim 1, wherein the pharmacological blocker comprises an Na⁺ channel blocker, a Ca²⁺ channel blocker, an NMDA receptor blocker and/or an opioid analgesic.

7. The method as in claim 1, wherein the pharmacological agent reduces an activation potential of a nerve fiber.

8. The method as in claim 1, wherein the pharmacological agent affects at least one Na⁺ channel and/or at least one Ca²⁺ channel.

9. A method of pharmacologically modulating a dorsal root ganglion comprising:

advancing a distal end of an elongate body along a portion of a peripheral nerve toward the dorsal root ganglion and a midline of a spinal column;

implanting the distal end near the dorsal root ganglion; and

delivering a pharmacological agent from an implanted delivery device through the distal end of the elongate body so that the pharmacological agent pharmacologically modulates the dorsal root ganglion, wherein the implanted delivery device comprises a reservoir for storing the pharmacological agent and a pump for moving the pharmacological agent from the reservoir to the elongate body.

10. The method as in claim 9, wherein the pharmacological agent modulates the dorsal root ganglion by acting upon at least one cell body within the dorsal root ganglion.

11. The method as in claim 9, wherein the pharmacological agent modifies electrophysiological excitability of the dorsal root ganglion.

12. The method of claim 11, wherein the electrophysiological excitability of the dorsal root ganglion is decreased at least in part by reducing the extent of membrane depolarization.

13. The method as in claim 9, wherein the pharmacological agent comprises a pharmacological blocker.

14. The method as in claim 13, wherein the pharmacological blocker comprises an Na⁺ channel blocker, a Ca⁺⁺ channel blocker, an NMDA receptor blocker or an opioid analgesic.

15. The method as in claim 9, wherein the pharmacological agent reduces an activation potential of a nerve fiber.

16. The method as in claim 9, wherein the pharmacological agent affects at least one Na⁺ channel and/or at least one Ca²⁺ channel.