Systems and methods for identifying anode placement based on cerebrospinal fluid thickness

• US 9,302,113 B2
• Filed: 07/22/2014
• Issued: 04/05/2016
• Est. Priority Date: 07/29/2013
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Ranu, Emarit A. S., Lee, Dongchul
• Primary Examiner(s): Porter, Jr., Allen
• Application Number:
  US14/338,306
• Publication Number:
  US 20150032187A1
• Time in Patent Office: 623 Days
• Field of Search: 607/62, 607115-117
• US Class Current: 1/1
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration

Abstract

A method of stimulating a portion of a spinal cord of a patient includes identifying an arrangement of electrodes including a relative placement of each electrode within the arrangement; identifying a vertebral level for implantation of the arrangement and a position of the arrangement with respect to the spinal cord; determining by calculation, for a selection of at least one cathode from the electrodes, at least two anode guard electrodes from the electrodes including in the calculation an estimated thickness of cerebrospinal fluid at the vertebral level; and stimulating the portion of the spinal cord of the patient at the vertebral level using the at least one cathode and the at least two anode guard electrodes.

Claims

1. A method of stimulating a portion of a spinal cord of a patient, the method comprising:

identifying an arrangement of a plurality of electrodes including a relative placement of each electrode within the arrangement;

identifying a vertebral level for implantation of the arrangement and a position of the arrangement with respect to the spinal cord;

determining by calculation, for a selection of a cathode from the plurality of electrodes, at least two anode guard electrodes from the plurality of electrodes including in the calculation an estimated thickness of cerebrospinal fluid at the vertebral level, wherein, in the calculation, a distance between each anode guard electrode and the cathode is inversely related to the estimated thickness of cerebrospinal fluid at the vertebral level; and

stimulating the portion of the spinal cord of the patient at the vertebral level using the cathode and the at least two anode guard electrodes.

2. The method of claim 1, further comprising, after determining the at least two anode guard electrodes, displaying an indication of the at least two anode guard electrodes for view by an operator.

3. The method of claim 2, wherein displaying an indication comprises displaying a schematic representation of the arrangement with an indication of which electrodes of the arrangement correspond to the at least two anode guard electrodes.

4. The method of claim 1, further comprising implanting one or more leads to form the arrangement of the plurality of electrodes.

5. The method of claim 4, wherein implanting one or more leads comprises implanting at least one paddle lead with the arrangement of the plurality of electrodes disposed thereon.

6. The method of claim 4, wherein implanting one or more leads comprises implanting at least two cylindrical leads to form the arrangement of the plurality of electrodes.

7. The method of claim 4, wherein implanting one or more leads comprises implanting at least one paddle lead and at least one cylindrical lead to form the arrangement of the plurality of electrodes disposed thereon.

8. A method of identifying a selection of electrodes for stimulating a portion of a spinal cord of a patient, the method comprising:

identifying an arrangement of a plurality of electrodes including a relative placement of each electrode within the arrangement;

identifying a vertebral level for implantation of the arrangement and a position of the arrangement with respect to the spinal cord;

determining by calculation, for a selection of a cathode from the plurality of electrodes, at least two anode guard electrodes from the plurality of electrodes including in the calculation an estimated thickness of cerebrospinal fluid at the vertebral level, wherein, in the calculation, a distance between each anode guard electrode and the cathode is inversely related to the estimated thickness of cerebrospinal fluid at the vertebral level;

displaying an indication of the at least two anode guard electrodes for view by a practitioner; and

transmitting to a control module of an electrical stimulation system the selection of the cathode and the determined at least two anode guard electrodes to initiate stimulation of a patient using the cathode and at least two anode guard electrodes.

9. The method of claim 8, further comprising implanting one or more leads to form the arrangement of the plurality of electrodes.

10. The method of claim 9, wherein implanting one or more leads comprises implanting at least one paddle lead with the arrangement of the plurality of electrodes disposed thereon.

11. The method of claim 9, wherein implanting one or more leads comprises implanting at least two cylindrical leads to form the arrangement of the plurality of electrodes.

12. The method of claim 9, wherein implanting one or more leads comprises implanting at least one paddle lead and at least one cylindrical lead to form the arrangement of the plurality of electrodes disposed thereon.

13. A non-transitory computer-readable storage medium having processor-executable instructions, the processor-executable instructions when installed onto a system enable the system to perform actions, comprising:

receiving an indication of an arrangement of a plurality of electrodes including a relative placement of each electrode within the arrangement;

receiving a vertebral level for implantation of the arrangement and a position of the arrangement with respect to the spinal cord;

determining by calculation, for a selection of a cathode from the plurality of electrodes, at least two anode guard electrodes from the plurality of electrodes including in the calculation an estimated thickness of cerebrospinal fluid at the vertebral level, wherein, in the calculation, a distance between each anode guard electrode and the cathode is inversely related to the estimated thickness of cerebrospinal fluid at the vertebral level;

displaying an indication of the at least two anode guard electrodes; and

transmitting to a control module of an electrical stimulation system the selection of the cathode and the determined at least two anode guard electrodes to initiate stimulation of a patient using the cathode and at least two anode guard electrodes.

14. The non-transitory computer-readable storage medium of claim 13, wherein the processor-executable instructions further comprise receiving an indication of whether the anode guard electrodes are to be mediolateral or rostrocaudal or a combination thereof with respect to the cathode.

15. A system for determining electrodes for use in electrical stimulation, the system comprising:

a display; and

at least one processor coupled to the display, the at least one processor is configured and arranged to

receive an indication of an arrangement of a plurality of electrodes including a including relative placement of each electrode within the arrangement;

receive a vertebral level for implantation of the arrangement and a position of the arrangement with respect to the spinal cord;

determine by calculation, for a selection of a cathode from the plurality of electrodes, at least two anode guard electrodes from the plurality of electrodes including in the calculation an estimated thickness of cerebrospinal fluid at the vertebral level, wherein, in the calculation, a distance between each anode guard electrode and the cathode is inversely related to the estimated thickness of cerebrospinal fluid at the vertebral level;

display on the display an indication of the at least two anode guard electrodes; and

transmit to a control module of an electrical stimulation system the selection of the cathode and the determined at least two anode guard electrodes to initiate stimulation of a patient using the cathode and at least two anode guard electrodes.

16. The system of claim 15, further comprising the control module configured and arranged to receive at least one implantable electrical stimulation lead.

17. The system of claim 16, wherein the control module comprises at least one of the at least one processor.

18. The system of claim 16, further comprising at least one lead configured and arranged for coupling to the control module.

19. The system of claim 15, wherein the at least one processor is also configured and arranged to receive an indication of whether the anode guard electrodes are to be mediolateral or rostrocaudal or a combination thereof with respect to the cathode.