Systems and methods for detecting intrathecal penetration

• US 9,358,388 B2
• Filed: 07/08/2014
• Issued: 06/07/2016
• Est. Priority Date: 09/30/2010
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Parker, Jon, Thacker, James R.
• Primary Examiner(s): SZMAL, BRIAN SCOTT
• Application Number:
  US14/326,301
• Publication Number:
  US 20150012077A1
• Time in Patent Office: 700 Days
• Field of Search: 607/46, 607/66, 607/40, 600/547
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36142 for improving safety

Abstract

Systems and methods for detecting intrathecal penetration are disclosed. A method in accordance with one embodiment includes detecting a value corresponding to an impedance of an electrical circuit that in turn includes an electrical contact located within the patient, and patient tissue adjacent to the electrical contact. The method further includes comparing the detected value to a predetermined criterion, and, if the detected value meets the predetermined criterion, identifying penetration of the patient'"'"'s dura based at least in part on the detected value.

Claims

1. A patient device, comprising:

an impedance detector electrically couplable to an electrical contact carried by a signal delivery device, wherein the signal delivery device carries a plurality of electrical contacts, and wherein the electrical contact is a distal-most electrical contact of the signal delivery device; and

a computer-readable medium operatively coupled to the impedance detector, the computer readable medium having instructions that, when executed, perform the following operations;

receive information from the impedance detector corresponding to an impedance of a circuit that includes the electrical contact and patient tissue adjacent to the electrical contact;

compare the detected impedance to a predetermined criterion; and

if the detected impedance meets the predetermined criterion, provide an indication that the patient'"'"'s dura has been penetrated.

2. The device of claim 1, wherein the indication includes an indication presented at a display device.

3. The device of claim 1, wherein the indication includes an aural indication.

4. The device of claim 1, wherein the predetermined criterion includes a reference impedance of 50 ohms or less.

5. The device of claim 1, wherein the predetermined criterion includes a reference impedance of 200 ohms or less.

6. The device of claim 1, wherein the plurality of electrical contacts includes contacts that are coupleable to a pulse generator to deliver a therapy signal to the patient, and wherein the electrical contact included in the circuit is an additional contact.

7. The device of claim 1, further comprising the signal delivery device, and wherein the signal delivery device and the electrical contact are coupleable to a pulse generator to deliver a therapy signal to the patient.

8. The device of claim 7, wherein the pulse generator is an implantable pulse generator.

9. The device of claim 7, wherein the pulse generator is an external pulse generator.

10. The device of claim 7, wherein the pulse generator is programmed to deliver a therapy signal at a frequency between 3 kHz and 50 kHz.

11. The device of claim 1, wherein the computer-readable medium further includes instructions that, when executed, perform the following operation:

if the detected value does not meet the predetermined criterion, provide an indication that the patient'"'"'s dura has not been penetrated.

12. The device of claim 1, further comprising the signal delivery device.

13. A patient device, comprising:

an implantable signal delivery device having a rounded tip;

a pair of electrical contacts carried by the signal delivery device; and

an intrathecal penetration detector, the intrathecal penetration detector including;

an impedance detector electrically coupled to the electrical contacts;

a processor;

a display device; and

a computer-readable medium operatively coupled to the impedance detector, the computer readable medium having instructions that, when executed, perform the following operations;

receive information from the impedance detector corresponding to an impedance of a circuit that includes the electrical contacts and patient tissue adjacent to the electrical contacts;

compare the detected impedance to a predetermined criterion; and

if the detected impedance meets the predetermined criterion, provide an indication at the display device that the patient'"'"'s dura has been penetrated.

14. The device of claim 13, further comprising a power source coupled to the signal delivery device.

15. The device of claim 13, wherein one of the electrical contacts forms the rounded tip of the signal delivery device.

16. The device of claim 13, wherein the predetermined criterion includes a reference impedance of 50 ohms or less.

17. The device of claim 13, wherein the predetermined criterion includes a reference impedance of 200 ohms or less.

18. The device of claim 13, wherein the computer-readable medium further includes instructions that, when executed, perform the following operation:

if the detected value does not meet the predetermined criterion, provide an indication that the patient'"'"'s dura has not been penetrated.

19. The device of claim 13, wherein the signal delivery device carries a plurality of electrical contacts that are coupleable to a pulse generator to deliver a therapy signal to the patient, and wherein the electrical contacts included in the circuit are special-purpose contacts.

20. The device of claim 13, wherein the signal delivery device and the electrical contacts are coupleable to a pulse generator to deliver a therapy signal to the patient.

21. A patient device, comprising:

an impedance detector electrically couplable to an electrical contact carried by a signal delivery device; and

a computer-readable medium operatively coupled to the impedance detector, the computer readable medium having instructions that, when executed, perform the following operations;

receive information from the impedance detector corresponding to an impedance of a circuit that includes the electrical contact and patient tissue adjacent to the electrical contact;

compare the detected impedance to a predetermined criterion; and

if the detected impedance meets the predetermined criterion, provide an indication that the patient'"'"'s dura has been penetrated, wherein the predetermined criterion includes a reference impedance of 50 ohms or less.

22. The device of claim 21, further comprising the signal delivery device.

23. A patient device, comprising:

an impedance detector electrically couplable to an electrical contact carried by a signal delivery device; and

a computer-readable medium operatively coupled to the impedance detector, the computer readable medium having instructions that, when executed, perform the following operations;

receive information from the impedance detector corresponding to an impedance of a circuit that includes the electrical contact and patient tissue adjacent to the electrical contact;

compare the detected impedance to a predetermined criterion;

if the detected impedance meets the predetermined criterion, provide an indication that the patient'"'"'s dura has been penetrated; and

if the detected value does not meet the predetermined criterion, provide an indication that the patient'"'"'s dura has not been penetrated.

24. The device of claim 23, further comprising the signal delivery device.