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

• US 9,604,059 B2
• Filed: 02/19/2015
• Issued: 03/28/2017
• Est. Priority Date: 04/02/2012
• Status: Active Grant

• Current Assignee: Nevro Corporation
• Original Assignee: Nevro Corporation
• Inventors: Parker, Jon
• Primary Examiner(s): Gedeon, Brian T
• Assistant Examiner(s): Tejani, Ankit D
• Application Number:
  US14/626,732
• Publication Number:
  US 20150217114A1
• Time in Patent Office: 768 Days
• Field of Search: None
• US Class Current: 1/1
• 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;

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;

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;

receive a third input corresponding to a medical indication of the patient, wherein the medical indication includes at least one of leg pain, low back pain, mid-back pain, upper back pain, total body pain, cervical pain, or cephalalgia;

receive a fourth input corresponding to a requested change in axial length of a computer-based image of the anatomical feature;

based at least in part on the first and second positional relationships, present a computer-based image of the first signal delivery device and a computer-based image of the second signal delivery device; and

automatically identify a signal delivery parameter in accordance with which a pulsed electrical signal is 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 has a predetermined correlation with the indication and at least one of the first positional relationship or the second positional relationship, and wherein the predetermined correlation is based at least in part on patient database information correlating signal delivery parameters and indications for other patients.

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

receive a fifth 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 fifth input, automatically update the signal delivery parameter.

3. The system of claim 2 wherein identifying the signal delivery parameter includes identifying a first electrode, and wherein updating the signal delivery parameter includes identifying a second electrode different than the first electrode.

4. The system of claim 1 wherein the anatomical feature includes at least one of a vertebrae or a disk of the patient.

5. The system of claim 4 wherein establishing the first positional relationship or establishing the second positional relationship includes establishing a positional relationship between an electrode of a corresponding at least one of the first signal delivery device or the second signal delivery device and the at least one vertebra.

6. The system of claim 1 wherein presenting the computer-based image of the first signal delivery device and the computer-based image of the second signal delivery device is based at least in part on measured data.

7. The system of claim 6 wherein the measured data includes impedance data associated with at least one of the first signal delivery device or the second signal delivery device.

8. A method for treating a patient, comprising:

receiving a first input corresponding to a location of a first signal delivery device implanted in a patient;

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

receiving a second input corresponding to a location of a second signal delivery device implanted in the patient;

establishing 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;

receiving a third input corresponding to a medical indication of the patient;

receiving a fourth input corresponding to a requested change in axial length of a computer-based image of the anatomical feature;

based at least in part on the first and second positional relationships, presenting a computer-based image of the first signal delivery device and a computer-based image of the second signal delivery device; and

automatically identifying a signal delivery parameter in accordance with which a pulsed electrical signal is 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 has a predetermined correlation with the indication and at least one of the first positional relationship or the second positional relationship, and wherein the predetermined correlation is based at least in part on patient database information correlating signal delivery parameters and medical indications for other patients.

9. The method of claim 8, further comprising delivering the pulsed electrical signal in accordance with the signal delivery parameter.

10. The method of claim 9 wherein delivering the pulsed electrical signal includes delivering the pulsed electrical signal at a frequency in a frequency range of from 1.5 kHz to 100 kHz.

11. The method of claim 9 wherein delivering the pulsed electrical signal includes delivering the pulsed electrical signal at a frequency in a frequency range of from 1.5 kHz to 50 kHz.

12. The method of claim 9 wherein delivering the pulsed electrical signal includes delivering the pulsed electrical signal at a frequency in a frequency range of from 3 kHz to 20 kHz.

13. The method of claim 8 wherein the anatomical feature includes at least one of a vertebrae or a disk of the patient.

14. The method of claim 8 wherein at least one of the first signal delivery device or the second signal delivery device includes a plurality of electrodes, and wherein the signal delivery parameter includes an identity of at least one of the electrodes to which the signal is delivered.

15. The method of claim 8 wherein the signal delivery parameter includes at least one of a signal frequency, amplitude or pulse width.

16. The method of claim 8, further comprising:

receiving a fifth input corresponding to a movement of at least one of the first signal delivery device or the second signal delivery device; and

based at least in part on the fifth input, automatically updating the signal delivery parameter.

17. The method of claim 16 wherein the signal delivery parameter includes an identity of an electrode carried by at least one of the first signal delivery device or the second signal delivery device.

18. The method of claim 8 wherein the anatomical feature includes at least one of a vertebrae or a disk of the patient, and wherein at least one of the first positional relationship or the second positional relationship is a positional relationship between at least one of the patient'"'"'s vertebrae and an electrode carried by at least one of the first signal delivery device or the second signal delivery device.

19. The method of claim 18, further comprising:

based at least in part on the second positional relationship, updating the signal delivery parameter for signals delivered from at least one of the first signal delivery device or the second signal delivery device.

20. The method of claim 18 wherein the signal delivery parameter is a first signal delivery parameter, and the first electrode carried by the at least one of the first signal delivery device or the second signal delivery device is a first electrode carried by the first signal delivery device, and wherein the method further comprises:

based at least in part on the second positional relationship, selecting an identity of a second electrode carried by the second signal delivery device, wherein the identity of the second electrode is a second signal delivery parameter in accordance with which signals are delivered to the patient from the second signal delivery device.

21. The method of claim 8 wherein at least one of the first input or the second input is received from a user operating an input device.

22. The method of claim 8 wherein at least one of the first input or the second input is automatically determined from a computer-based image of the signal delivery device.

23. The method of claim 8 wherein the medical indication is selected from a list of medical indications comprising back pain, leg pain, total body pain and headache pain.

24. The method of claim 8 wherein automatically identifying a signal delivery parameter includes identifying the signal delivery parameter based at least in part on a pre-existing relationship between the indication and the signal delivery parameter.

25. The method of claim 24 wherein the relationship is obtained from patients other than the patient to whom the pulsed electrical signal is delivered.

26. The method of claim 25 wherein the patient is one of multiple patients presenting with the indication, and wherein the method further comprises updating the patient database information with data from the one patient.

27. The method of claim 8 wherein the signal delivery parameter has a first value, and wherein the method further comprises replacing the first value with a second value in response to an event.

28. The method of claim 27 wherein the first value is an identity of a first electrode, the second value is an identity of a second electrode different than the first electrode, and the event is an indication that a circuit that includes the first electrode has an impedance higher or lower than a target value.

29. The method of claim 8 wherein at least one of the first signal delivery device or the second signal delivery device includes an elongated spinal cord lead, and wherein:

receiving the first input or receiving the second input includes receiving an input corresponding to the location of an electrode carried by the lead;

establishing the first positional relationship or establishing the second positional relationship includes establishing a distance between the lead and a vertebra of the patient;

receiving the third input includes receiving an input corresponding to an indication of patient pain; and

automatically identifying the signal delivery parameter includes identifying at least one electrode of the lead as an active electrode to which the pulsed electrical signal is delivered.

30. The method of claim 8 wherein the medical indication includes at least one of low back pain or leg pain.

31. The method of claim 8 wherein the medical indication includes at least one of leg pain, low back pain, mid-back pain, upper back pain, total body pain, cervical pain, or cephalalgia.

32. 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;

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

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;

receive a third input identifying a medical indication of the patient;

receive a fourth input corresponding to a requested change in axial length of a computer-based image of the anatomical feature;

based at least in part on the first and second positional relationships, align at least one of a computer-based image of the first lead or a computer-based image of the second lead relative to the other of the computer-based image of the first lead or the computer-based image of the second lead;

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

based at least in part on the predetermined correlation, automatically identify at least one electrode, carried by at least one of the first and second leads, and deliver a pulsed electrical signal to the patient'"'"'s spinal cord via the at least one electrode.

33. The system of claim 32 wherein aligning at least one of the computer-based image of the first lead or the computer-based image of the second lead is based at least in part on measured data.

34. The system of claim 33 wherein the measured data includes impedance data associated with at least one of the first lead or the second lead.