Devices for controlling spinal cord modulation for inhibiting pain, and associated systems and methods, including controllers for automated parameter selection

• US 10,076,665 B2
• Filed: 03/22/2017
• Issued: 09/18/2018
• Est. Priority Date: 04/02/2012
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Parker, Jon
• Primary Examiner(s): Tejani, Ankit D
• Application Number:
  US15/466,738
• Publication Number:
  US 20170239479A1
• Time in Patent Office: 545 Days
• Field of Search: None
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36075 Headache or migraine
• CPC Class Codes: A61N 1/36128 Control systems
• 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

Devices for controlling spinal cord modulation for inhibiting pain, and associated systems and methods, including controllers for automated parameter selection are disclosed. A particular embodiment includes receiving a first input corresponding to a location of a signal delivery device implanted in a patient, establishing a positional relationship between the signal delivery device and an anatomical feature of the patient, receiving a second input corresponding to a medical indication of the patient, and, based at least in part on the positional relationship and the indication, automatically identifying a signal delivery parameter in accordance with which a pulsed electrical signal is delivered to the patient via the signal delivery device.

Claims

1. A patient treatment system, comprising:

a non-transitory computer-readable medium having instructions that, when executed;

receive a first input corresponding to a location of a first signal delivery device implanted in a patient, the first signal delivery device including a first plurality of contacts;

establish a first positional relationship between the location of the first signal delivery device and an anatomical feature of the patient;

receive a second input corresponding to a location of a second signal delivery device implanted in the patient, the second signal delivery device including a second plurality of contacts;

establish a second positional relationship between the location of the second signal delivery device and at least one of the location of the first signal delivery device or the anatomical feature of the patient;

identify one or more contacts of the first plurality of contacts for delivering therapy to the patient, wherein the identified one or more contacts are (a) located at a target vertebral level of the patient, and (b) have impedance values within a pre-established range;

based at least in part on impedance values of one or more of the second plurality of contacts, align a computer-based image of the second signal delivery device relative to a computer-based image of the first signal delivery device; and

automatically identify a signal delivery parameter value for a pulsed electrical signal that is to be delivered to the patient via at least one of the first signal delivery device or the second signal delivery device, wherein the signal delivery parameter value has a predetermined correlation with at least one of the first positional relationship or the second positional relationship.

2. The system of claim 1 wherein the predetermined correlation is further based at least in part on patient database information correlating signal delivery parameters and indications for other patients.

3. The system of claim 1 wherein the instructions, when executed:

receive a third input corresponding to an updated location of at least one of the first signal delivery device or the second signal delivery device; and

in response to the third input, automatically update the signal delivery parameter value.

4. The system of claim 1 wherein establishing the first positional relationship includes establishing a positional relationship between the anatomical feature of the patient and one or more of the first plurality of contacts.

5. The system of claim 1 wherein the first plurality of contacts and the second plurality of contacts are operable to deliver the pulsed electrical signal to the patient.

6. The system of claim 1 wherein the computer-based image of the first signal delivery device and the computer-based image of the second signal delivery device are displayed on a display, and wherein the display further includes vertebral level identifiers corresponding to the anatomical feature of the patient, and lead identifiers corresponding to the first signal delivery device and second signal delivery device.

7. The system of claim 6 wherein the instructions, when executed:

receive a third input to adjust the location of one or more of the lead identifiers relative to the vertebral level identifiers.

8. The system of claim 6 wherein each lead identifier includes a contact lead identifier, and wherein automatically identifying a signal delivery parameter value is based at least in part on impedance indicated at the contact lead identifier.

9. The system of claim 1 wherein aligning the computer-based image of the second signal delivery device is further based on the impedance values of one or more of the first plurality of contacts.

10. The system of claim 1 wherein the instructions, when executed, prevent one or more of the first plurality of contacts from being used to deliver therapy to the patient, wherein the prevented one or more contacts have impedance values outside the pre-established range.

11. The system of claim 1 wherein the instructions, when executed, receive a third input corresponding to a medical indication of the patient, and wherein the predetermined correlation is between the indication and at least one of the first positional relationship or the second positional relationship.

12. A patient treatment system, comprising:

an implantable signal generator;

a first elongated signal delivery lead coupled to the implantable signal generator and positioned proximate to a patient'"'"'s spinal cord, the first lead including a first plurality of contacts;

a second elongated signal delivery lead coupled to the implantable signal generator and positioned proximate to the patient'"'"'s spinal cord, the second lead including a second plurality of contacts; and

a programmer in wireless communication with the implantable signal generator, the programmer having a computer-readable medium with instructions that, when executed;

receive a first input indicating a location of the first lead;

receive a second input indicating a location of the second lead;

establish a first positional relationship between the first lead and a vertebra of the patient;

establish a second positional relationship between the second lead and at least one of the first lead or the vertebra of the patient;

identify one or more contacts of the first plurality of contacts for delivering a pulsed electrical signal to the patient, wherein the identified one or more contacts have impedance values within a pre-established range;

based at least in part on impedance values of one or more of the second plurality of contacts, align a computer-based image of the second lead relative to a computer-based image of the first lead;

access an established database of patient information, wherein the database includes a predetermined correlation including the first and second positional relationships for other patients; and

based at least in part on the predetermined correlation, automatically identify a value of a signal delivery parameter for a pulsed electrical signal to be delivered to the patient'"'"'s spinal cord via at least one of the first or second pluralities of contacts.

13. The system of claim 12 wherein the instructions, when executed:

receive a third input corresponding to an updated location of at least one of the first lead or the second lead; and

in response to the third input, automatically update the signal delivery parameter value for delivering the pulsed electrical signal to the patient'"'"'s spinal cord.

14. The system of claim 13 wherein the signal delivery parameter includes at least one of frequency, amplitude or pulse width.

15. The system of claim 14 wherein the instructions, when executed, automatically update the signal delivery parameter value, in response to the third input.

16. The system of claim 12 wherein the computer-based image of the first lead and the computer-based image of the second lead are displayed on a display, and wherein the display further includes vertebral level identifiers corresponding to the vertebra of the patient, and lead identifiers corresponding to the first and second leads, and wherein the instructions, when executed:

receive a third input to adjust the location of one or more of the lead identifiers relative to the vertebral level identifiers.

17. The system of claim 12 wherein the predetermined correlation further includes a medical indication of the patient.

18. A method of operating a patient treatment system, the method comprising:

establishing a first positional relationship between a location of a first signal delivery device and an anatomical feature of a patient, the first signal delivery device including a first plurality of contacts;

establishing a second positional relationship between a location of a second signal delivery device and at least one of the location of the first signal delivery device or the anatomical feature of the patient;

identifying one or more contacts for delivering therapy to the patient, wherein the identified one or more contacts have impedance values within a pre-established range; and

based at least in part on impedance values of one or more of the second plurality of contacts, aligning a computer-based image of the second signal delivery device relative to a computer-based image of the first signal delivery device.

19. The method of claim 18, further comprising automatically identifying a value for a signal delivery parameter for a pulsed electrical signal to be delivered to the patient via at least one of the first or second pluralities of contacts, wherein the signal delivery parameter value has a predetermined correlation between a medical indication of the patient and at least one of the first positional relationship or the second positional relationship.

20. The method of claim 19, further comprising delivering the pulsed electrical signal having the signal delivery parameter value to the patient'"'"'s spinal cord.

21. The method of claim 18, wherein the first positional relationship is established between a location of one or more of the first plurality of contacts and the anatomical feature of the patient, and wherein the second positional relationship is established between a location of one or more of the second plurality of contacts and (a) the anatomical feature of the patient or (b) one or more of the first plurality of contacts.