Programming interface for spinal cord neuromodulation

• US 9,867,989 B2
• Filed: 11/10/2014
• Issued: 01/16/2018
• Est. Priority Date: 06/14/2010
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Blum, David Arthur, Schulte, Gregory T., Kokones, Scott, Carlton, Keith
• Primary Examiner(s): Desire, Gregory M
• Application Number:
  US14/537,299
• Publication Number:
  US 20150066111A1
• Time in Patent Office: 1,163 Days
• CPC Class Codes: A61B 2090/368 changing the image on a display according to the operator's position
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36182 Direction of the electrical field, e.g. with sleeve around stimulating electrode
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A tool for assisting in the planning or performing of electrical neuromodulation of a patient'"'"'s spinal cord. The tool may have various functions and capabilities, including calculating a volume of activation, registering an electrode(s) shown in a radiologic image, constructing functional images of the patient'"'"'s spinal anatomy, targeting of neuromodulation, finding a functional midline between multiple electrodes, determining the three-dimensional position of multiple electrodes, and/or accommodating for electrode migration. In certain embodiments, the tool can be embodied as computer software or a computer system.

Claims

1. A method for assisting planning or performing of neuromodulation in a patient, comprising:

receiving a first radiologic image showing an electrode and an anatomic region of the patient;

receiving a second radiologic image showing the electrode and the anatomic region of the patient, wherein the second radiologic image provides a different view than the first radiologic image;

using the first radiologic image and the second radiologic image to determine a three-dimensional position of the electrode in relation to the anatomic region; and

displaying the electrode and a display image of the anatomic region on a display screen.

2. The method of claim 1, wherein the first radiologic image and second radiologic image show multiple electrodes, and further comprising:

using the first radiologic image and the second radiologic image to determine the three-dimensional position of the multiple electrodes in relation to each other.

3. The method of claim 1, wherein the first radiologic image and second radiologic image are x-ray images.

4. The method of claim 3, wherein the first radiologic image is an anterior-posterior view x-ray image and the second radiologic image is a lateral view x-ray Image.

5. The method of claim 1, wherein the anatomic region is a spinal anatomy of the patient.

6. The method of claim 1, further comprising:

determining a functional midline for the electrode; and

displaying on the display screen, an image of the anatomic region and the electrode such that the functional midline of the electrode is aligned to a physiologic midline of the anatomic region.

7. The method of claim 6, wherein the anatomic region is a spinal cord.

10. The method of claim 6, wherein determining the functional midline comprises:

receiving information about a first relative electrical neuromodulation intensity between a first electrode contact among multiple electrode contacts and a first counterpart electrode contact among the multiple electrode contacts; and

based on the first relative electrical neuromodulation intensity, determining a first midpoint between the first electrode contact and the first counterpart electrode contact.

11. The method of claim 10, wherein determining the functional midline further comprises:

receiving information about a second relative electrical neuromodulation intensity between a second electrode contact among the multiple electrode contacts and a second counterpart electrode contact among the multiple electrode contacts;

based on the second relative electrical neuromodulation intensity, determining a second midpoint between the second electrode contact and the second counterpart electrode contact; and

establishing the functional midline as a line between the first midpoint and the second midpoint.

12. The method of claim 10, wherein multiple electrodes are located in the first radiologic image;

and wherein the first electrode contact is on a first one of the multiple electrodes and the first counterpart electrode contact is on a second one of the multiple electrodes.

13. The method of claim 12, wherein determining the functional midline further comprises:

receiving information about a second relative electrical neuromodulation intensity between a second electrode contact on the first one of the multiple electrodes and a second counterpart electrode contact on the second one of the multiple electrodes;

based on the second relative electrical neuromodulation intensity, determining a second midpoint between the second electrode contact and the second counterpart electrode contact; and

establishing the functional midline as a line between the first midpoint and the second midpoint.

14. The method of claim 12, further comprising determining a relative position of the multiple electrodes in relation to each other.

15. The method of claim 10, wherein the first relative electrical neuromodulation intensity between the first electrode contact and the first counterpart electrode contact is an electrode neuromodulation setting that produces a parasthesia that is centered on the patient'"'"'s body.

8. A computer system that is programmed to perform steps that comprise:

receiving a first radiologic image showing an electrode and an anatomic region of the patient;

receiving a second radiologic image showing the electrode and the anatomic region of the patient, wherein the second radiologic image provides a different view than the first radiologic image; and

using the first radiologic image and the second radiologic image to determine a three-dimensional position of the electrode in relation to the anatomic region.

9. The method of claim 8, wherein the anatomic region is a spinal anatomy of the patient.

16. The computer system of claim 8, wherein the computer system is further programmed to perform actions that comprise:

determining a functional midline for the electrode.

17. A non-transitory computer-readable storage medium comprising instructions executable by a computer processor, the instructions which, when executed by the processor, cause the processor to perform a method, the method comprising:

receiving a first radiologic image showing an electrode and an anatomic region of the patient;

receiving a second radiologic image showing the electrode and the anatomic region of the patient, wherein the second radiologic image provides a different view than the first radiologic image; and

using the first radiologic image and the second radiologic image to determine a three-dimensional position of the electrode in relation to the anatomic region.

18. The method of claim 17, wherein the anatomic region is a spinal anatomy of the patient.

19. The non-transitory computer-readable storage medium of claim 17, wherein the instructions, when executed by the processor, further cause the processor to perform actions, the actions comprising:

determining a functional midline for the electrode.