Systems and methods for delivering neural therapy correlated with patient status

• US 9,669,219 B2
• Filed: 11/17/2015
• Issued: 06/06/2017
• Est. Priority Date: 02/10/2009
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Caparso, Anthony V., Walker, Andre B., Chitre, Yougandh, Parker, Jon
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US14/944,069
• Publication Number:
  US 20160144187A1
• Time in Patent Office: 567 Days
• Field of Search: None
• CPC Class Codes: A61N 1/025 Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36062 Spinal stimulation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

Therapy systems for treating a patient are disclosed. Representative therapy systems include an implantable pulse generator, a signal delivery device electrically coupled to the pulse generator, and a remote control in electrical communication with the implantable pulse generator. The pulse generator can have a computer-readable medium containing instructions for performing a process that comprises collecting the patient status and stimulation parameter; analyzing the collected patient status and stimulation parameter; and establishing a preference baseline containing a preferred stimulation parameter corresponding to a particular patient status.

Claims

1. A computer-implemented method for treating a patient, comprising:

during a first phase;

establishing a preference baseline containing a plurality of patient preferences, wherein the plurality of patient preferences include patient-preferred values of stimulation parameters correlated with corresponding values of patient status; and

prioritizing the plurality of patient preferences to generate a preference-ordered list; and

during a second phase;

delivering a first therapy signal to a spinal cord region of the patient via an implantable pulse generator and an implantable signal delivery device, wherein the first therapy signal includes a first plurality of values of stimulation parameters, and wherein the first plurality of values of stimulation parameters comprise a first subset of the patient-preferred values of stimulation parameters;

monitoring a value of a particular patient status;

in response to a change in the value of the particular patient status, automatically stopping delivery of the first therapy signal, and automatically initiating delivery of a second therapy signal, wherein the second therapy signal includes a second plurality of values of stimulation parameters, and wherein the second plurality of values of stimulation parameters comprise a second subset of the patient-preferred values of stimulation parameters; and

in response to an override of the automatic initiation of the second therapy signal, presenting at least a portion of the preference-ordered list.

2. The computer-implemented method of claim 1 wherein monitoring the value of the patient status includes monitoring the value of the patient status via a sensing element to determine an activity level of the patient.

3. The computer-implemented method of claim 1 wherein monitoring the value of the patient status includes monitoring the value of the patient status via a sensing element to determine a posture of the patient.

4. The computer-implemented method of claim 1 wherein the first plurality of values of stimulation parameters include an identity of a first contact of the signal delivery device, and wherein the second plurality of values of stimulation parameters include an identity of a second contact of the signal delivery device.

5. The computer-implemented method of claim 4 wherein the first contact is positioned to deliver the first therapy signal to treat a first pain area, and the second contact is positioned to deliver the second therapy signal to treat a second pain area.

6. The computer-implemented method of claim 5 wherein at least one of the first contact and the second contact is positioned to treat lower back pain.

7. The computer-implemented method of claim 1 wherein the first plurality of values of stimulation parameters include a first amplitude, and wherein the second plurality of values of stimulation parameters include a second amplitude.

8. The computer-implemented method of claim 1 wherein monitoring the value of the particular patient status includes measuring an impedance via the implantable signal delivery device.

9. A computer-implemented method for treating a patient, comprising:

during a first phase;

establishing a preference baseline containing a plurality of patient preferences, wherein the plurality of patient preferences include patient-preferred values of stimulation parameters correlated with corresponding values of patient status; and

prioritizing the plurality of patient preferences to generate a preference-ordered list; and

during a second phase;

delivering a first therapy signal to a first spinal cord region of the patient via a first contact of an implantable signal delivery device;

monitoring a value of a particular patient status;

in response to a change in the value of the particular patient status, automatically stopping delivery of the first therapy signal via the first contact, and automatically initiating delivery of a second therapy signal to a second spinal cord region of the patient via a second contact of the implantable signal delivery device; and

in response to an override of the automatic initiation of the second therapy signal, presenting at least a portion of the preference-ordered list.

10. The computer-implemented method of claim 9 wherein at least one of the first therapy signal and the second therapy signal is delivered to treat back pain.

11. The computer-implemented method of claim 9 wherein monitoring the value of the particular patient status includes monitoring an impedance via the implantable signal delivery device.

12. The computer-implemented method of claim 9 wherein the change in the value of the particular patient status corresponds to a change in an activity level.

13. A therapy system for treating a patient, comprising:

a signal delivery device having a plurality of contacts; and

an implantable pulse generator electrically coupleable to the signal delivery device to apply therapy signals to a spinal cord region of the patient, wherein the implantable pulse generator includes a computer-readable medium containing instructions for performing a process comprising;

during a first phase;

establishing a preference baseline containing a plurality of patient preferences, wherein the plurality of patient preferences include patient-preferred values of stimulation parameters correlated with corresponding values of patient status; and

prioritizing the plurality of patient preferences to generate a preference-ordered list; and

during a second phase;

delivering a first therapy signal via a first contact configuration;

in response to a change from a first value of patient status to a second value of patient status, automatically stopping delivery of the first therapy signal via the first contact configuration, and automatically initiating delivery of a second therapy signal via a second contact configuration; and

in response to an override of the automatic initiation of the second therapy signal, presenting at least a portion of the preference-ordered list.

14. The therapy system of claim 13 wherein the first contact configuration includes a first contact positionable to treat a first target area, and the second contact configuration includes a second contact positionable to treat a second target area.

15. The therapy system of claim 14 wherein the first target area corresponds to lower back pain, and wherein the second target area does not correspond to lower back pain.

16. The therapy system of claim 13, further comprising a sensing element positionable to determine individual values of patient status.

17. The therapy system of claim 16 wherein the sensing element measures impedance.

18. The therapy system of claim 13 wherein the first value of patient status and the second value of patient status correspond to activity levels of the patient.

19. The therapy system of claim 13 wherein the first value of patient status and the second value of patient status correspond to postures of the patient.

20. The therapy system of claim 13 wherein the first therapy signal includes a first amplitude and the second therapy signal includes a second amplitude different than the first amplitude.