171 results about "Spinal nerve" patented technology

A neurostimulating lead is provided for use in stimulating the spinal chord, spinal nerves, or peripheral nerves or for use in deep brain stimulation that comprises an elongated, flexible lead having improved steerability properties. The lead includes a plurality of thin-film metal electrodes connected by conductors embedded within the wall of the lead to electrical contacts at the proximal end of the lead. The lead is further designed to include an internal lumen for use with a guidewire in an over-the-wire lead placement.

The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for treating herniated or swollen discs within a patient's spine by applying sufficient electrical energy to the disc tissue to contract or shrink the collagen fibers within the nucleus pulposis. This causes the pulposis to shrink and withdraw from its impingement on the spinal nerve.

A method of determining relative neuro-muscular response onset value thresholds for a plurality of spinal nerves, comprising: depolarizing a portion of the patient's cauda equina; and measuring the current intensity level at which a neuro-muscular response to the depolarization of the cauda equina is detected in each of the plurality of spinal nerves. A method for detecting the presence of a nerve adjacent the distal end of at least one probe, comprising: determining relative neuro-muscular response onset values for a plurality of spinal nerves; emitting a stimulus pulse from a probe or surgical tool; detecting neuro-muscular responses to the stimulus pulse in each of the plurality of spinal nerves; and concluding that the electrode disposed on the distal end of the at least one probe is positioned adjacent to a first spinal nerve when the neuro-muscular response detected in the first spinal nerve is detected as a current intensity level less than or equal to a corresponding neuro-muscular response onset value of the first spinal nerve.

Some embodiments of the present invention provide methods and systems for modulating neural tissue including systems and components for selective stimulation and / or neuromodulation of targeted neural tissue. Targeted neural tissue may include one or more ganglia including those of the spinal nerves in the dorsal root and the sympathetic chain. Methods also include implantation of an electrode on, in or around a dorsal root ganglia. Some other embodiments of the present invention provide methods for selective neurostimulation of one or more dorsal root ganglia as well as techniques for applying neurostimulation to the spinal cord. Still other embodiments of the present invention provide stimulation systems and components for selective stimulation and / or neuromodulation of one or more dorsal root ganglia through implantation of an electrode on, in or around a dorsal root ganglia in combination with a pharmacological agent.

Systems for determining structural integrity of a bone within the spine of a patient, the bone having a first aspect and a second aspect, wherein the second aspect separated from the first aspect by a width and located adjacent to a spinal nerve. A stimulator is configured to generate an electrical stimulus to be applied to the first aspect of the bone. A monitor is configured to electrically monitor a muscle myotome associated with the spinal nerve to detect if an onset neuro-muscular response occurs in response to the application of the electrical stimulus to the first aspect of the bone. An adjuster is configured to automatically increase the magnitude of the electrical stimulus to until the onset neuro-muscular response is detected. Lastly, a communicator is configured to communicate to a user via at least one of visual and audible means information representing the magnitude of the electrical stimulus which caused the onset neuro-muscular response.

A method of determining relative neuro-muscular response onset value thresholds for a plurality of spinal nerves, comprising: depolarizing a portion of the patient's cauda equina; and measuring the current intensity level at which a neuro-muscular response to the depolarization of the cauda equina is detected in each of the plurality of spinal nerves. A method for detecting the presence of a nerve adjacent the distal end of at least one probe, comprising: determining relative neuro-muscular response onset values for a plurality of spinal nerves; emitting a stimulus pulse from a probe or surgical tool; detecting neuro-muscular responses to the stimulus pulse in each of the plurality of spinal nerves; and concluding that the electrode disposed on the distal end of the at least one probe is positioned adjacent to a first spinal nerve when the neuro-muscular response detected in the first spinal nerve is detected as a current intensity level less than or equal to a corresponding neuro-muscular response onset value of the first spinal nerve.

Methods for determining structural integrity of a bone within the spine of a patient, the bone having a first aspect and a second aspect, wherein the second aspect separated from the first aspect by a width and located adjacent to a spinal nerve. The methods involve (a) applying an electrical stimulus to the first aspect of the bone; (b) electrically monitoring a muscle myotome associated with the spinal nerve to detect if an onset neuro-muscular response occurs in response to the application of the electrical stimulus to the first aspect of the bone; (c) automatically increasing the magnitude of the electrical stimulus to until the onset neuro-muscular response is detected; and (d) communicating to a user via at least one of visual and audible means information representing the magnitude of the electrical stimulus which caused the onset neuro-muscular response.

Devices, systems and methods are provided for accessing and treating anatomies associated with a variety of conditions while minimizing possible complications and side effects. This is achieved by directly neuromodulating a target anatomy associated with the condition while minimizing or excluding undesired neuromodulation of other anatomies. Typically, this involves stimulating portions of neural tissue of the central nervous system, wherein the central nervous system includes the spinal cord and the pairs of nerves along the spinal cord which are known as spinal nerves. In particular, some embodiments of the present invention are used to selectively stimulate portions of the spinal nerves, particularly one or more dorsal root ganglions (DRGs), to treat chronic pain while causing minimal deleterious side effects such as undesired motor responses.

A spinal nerve tissue ablation apparatus includes a stylet needle with a distal end having a rounded blunt tip sufficiently sharp to penetrate tissue but sufficiently blunt to avoid impinging on bony surfaces of spinal vertebra. The apparatus includes an energy delivery device having at least a first electrode and a second electrode. Each electrode has a tissue piercing distal end and is positionable in the stylet as the stylet is advanced through tissue. The first and second electrodes are deployable with curvature from the stylet. The stylet includes rotational means for orienting the first and second electrodes and directing the extension according to the curvature of the electrodes. The stylet further includes an optical imaging module to provide continual progressive feedback of ablation surface development. The apparatus further includes an ultra-wide band radio frequency scanning device capable of accurately determining the location of the electrodes within the spinal structure.

It has been discovered that pain felt in a given region of the body can be treated, not by motor point stimulation of muscle in the local region where pain is felt, but by stimulating muscle close to a “nerve of passage” in a region that is superior (i.e., cranial or upstream toward the spinal column) to the region where pain is felt. Spinal nerves such as the intercostal nerves or nerves passing through a nerve plexus, which comprise trunks that divide by divisions and / or cords into branches, comprise “nerves of passage.”

The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for treating herniated or swollen discs within a patient's spine by applying sufficient electrical energy to the disc tissue to contract or shrink the collagen fibers within the nucleus pulposis. This causes the pulposis to shrink and withdraw from its impingement on the spinal nerve.

Apparatus and methods for performing spinal disc lesioning procedures while monitoring the temperature near the spinal nerve roots. A needle containing a thermocouple and an injection bore may be placed between the disc and a nerve root. Temperature near the nerve root may be monitored during the lesioning procedure and if raised to a point where damage to the nerve could occur, the procedure may be stopped before damage is done. Coolant may be injected through the injection bore to lower the temperature near the nerve root. Additional dual purpose needles may be placed on the disc adjacent the opposite nerve root or in the spinal canal at the level of the disc for additional control. A hollow, flexible tip electrode needle may be used to repair and lesion the disc tissue. Prior to lesioning, the electrode may be stimulated to assess motor nerve response and avoid motor nerve damage.

A rotatable surgical burr (100, 200, 300, 500) having a protective hood (120, 220, 320, 520, 620, 720) with a dissecting foot plate (119, 219, 319, 519, 619, 719) is provided to improve and enable various spinal decompression procedures. The surgical burr's protective hood has a dissecting foot plate that may be shaped to resemble a curette, a Woodson, or other appropriate dissecting tools to allow insertion of the tool between the spinal nerve and the compressing bone. The protective hood surrounds the burr bit (130, 230, 530) exposing only a portion of the burr bit for burring of the offending bone and protects the nerve from the burr tip. The instrument may also be configured with a soft tissue resecting tip (330) for soft tissue resection.

A method for modulating nerve tissue in a body of a patient includes implanting a wireless stimulation device in proximity to a dorsal root ganglion or an exiting nerve root such that an electrode, circuitry and a receiving antenna are positioned completely within the body of the patient. An input signal containing electrical energy and waveform parameters is transmitted to the receiving antenna(s) from a control device located outside of the patient's body via radiative coupling. The circuitry within the stimulation device generates one or more electrical impulses and applies the electrical impulses to the dorsal root ganglion or the exiting nerve roots through the electrode.

A method for treating an ailment of a patient using at least one electrode implanted within a spinal column of the patient at a T4-T6 spinal nerve level. The method comprises increasing an activation threshold of a side-effect exhibiting neural structure relative to the activation threshold of a dorsal column (DC) nerve fiber of the patient, and applying electrical stimulation energy to the DC nerve fiber via the at least one electrode while the activation threshold of the neural structure is increased, thereby treating the ailment while minimizing stimulation of the neural structure. Another method comprises applying electrical stimulation energy to the spinal column of the patient via the plurality of electrodes, thereby generating a medio-lateral electrical field relative to the spinal column of the patient and treating the ailment.

It has been discovered that pain felt in a given region of the body can be treated, not by motor point stimulation of muscle in the local region where pain is felt, but by stimulating muscle spaced from a “nerve of passage” in a region that is superior (i.e., cranial or upstream toward the spinal column) to the region where pain is felt. Spinal nerves such as the intercostal nerves or nerves passing through a nerve plexus, which comprise trunks that divide by divisions and / or cords into branches, comprise “nerves of passage.”

A method for modulating nerve tissue in a body of a patient includes implanting a wireless stimulation device in proximity to a dorsal root ganglion or an exiting nerve root such that an electrode, circuitry and a receiving antenna are positioned completely within the body of the patient. An input signal containing electrical energy and waveform parameters is transmitted to the receiving antenna(s) from a control device located outside of the patient's body via radiative coupling. The circuitry within the stimulation device generates one or more electrical impulses and applies the electrical impulses to the dorsal root ganglion or the exiting nerve roots through the electrode.

A method and apparatus for treating a condition associated with impaired blood pressure and / or heart rate in a subject comprising applying an electrical treatment signal, wherein the electrical treatment signal is selected to at least partially block nerve impulses, or in some embodiments, to augment nerve impulses. In embodiments, the apparatus provides a first therapy program to provide a downregulating signal to one or more nerves including renal artery, renal nerve, vagus nerve, celiac plexus, a splanchnic nerve, cardiac sympathetic nerves, spinal nerves originating between T10 to L5. In embodiments, the apparatus provides a third therapy program to provide an upregulating signal to one or more nerves including a glossopharyngeal nerve and / or a tissue containing baroreceptors.

The present invention relates to a method for directed cell in-growth and controlled tissue regeneration to prevent post-surgical or post-traumatic adhesion and fibrosis formation on the injured surface of a tissue selected from the group consisting of spinal column tissue, dura mater, and spinal nerves in a mammal, comprising the step of providing, covering and separating the tissue with a bioactive biofunctional, non-porous, microscopically multilayered collagen foil biomatrix, and to a method for treating a defect in a mammal comprising the step of providing, covering and separating said tissue with a bioactive biofunctional, non-porous, microscopically multilayered collagen foil biomatrix.

A method for treating a pulmonary disorder in a subject includes inserting a therapy delivery device into a vessel of the subject, advancing the therapy delivery device to a point adjacent an intraluminal target site of the autonomic nervous system, and activating the therapy delivery device to delivery a therapy signal to the intraluminal target site to treat the pulmonary disorder. The intraluminal target site is in electrical communication with nervous tissue selected from the group consisting of a spinal nerve, a postganglionic fiber of a spinal nerve, a sympathetic chain ganglion, a thoracic sympathetic chain ganglion, a cervical ganglion, a lower cervical ganglion, an inferior cervical ganglion, an intramural ganglion, a splanchnic nerve, an esophageal plexus, a cardiac plexus, a pulmonary plexus, an anterior pulmonary plexus, a posterior pulmonary plexus, a celiac plexus, a hypogastric plexus, an inferior mesenteric ganglion, a celiac ganglion, and a superior mesenteric ganglion.

A method for treating asthma in a subject includes inserting a therapy delivery device into a vessel of a subject. The therapy delivery device is advanced to a point substantially adjacent an intraluminal target site of the autonomic nervous system. Next, the therapy delivery device is activated to deliver a therapy signal to the intraluminal target site to treat the asthma. The intraluminal target site is in electrical communication with nervous tissue selected from the group consisting of a spinal nerve, pre- or post-ganglionic autonomic fibers, a sympathetic chain ganglion, a thoracic sympathetic chain ganglion, a cervical ganglion, a lower cervical ganglion, an inferior cervical ganglion, an intramural ganglion, a splanchnic nerve, an esophageal plexus, a cardiac plexus, a pulmonary plexus, an anterior pulmonary plexus, a posterior pulmonary plexus, a celiac plexus, a hypogastric plexus, an inferior mesenteric ganglion, a celiac ganglion, and a superior mesenteric ganglion.

A method of accessing target tissue adjacent to a spinal nerve of a patient includes the steps of accessing a spine location of the patient by entering the patient through the skin at an access location, inserting a flexible tissue modification device through the access location to the spine location, advancing a distal portion of the first flexible tissue modification device from the spine location to a first exit location, passing through the first exit location and out of the patient, advancing the first or a second flexible tissue modification device through the same access location to the spine location and to a second exit location, and passing through the second exit location and out of the patient.

A vertebral attachment method and system that minimizes or eliminates the risk of severing, compressing, impinging or otherwise injuring the vertebral artery vertebral vein, spinal nerve roots and / or spinal cord. The system includes at least one plate that may be anchored to a posterior region of a vertebra using at least one clamp and fastener. The system may be specifically designed to retain a portion of the posterior region of the vertebra.

An apparatus for stimulating regeneration and repair of damaged spinal nerves, comprising at least two electrodes placed intravertebrally near the site of spinal axon injury and delivering DC current thereto. A method for stimulating regeneration and repair of damaged spinal nervous tissue, comprising placing electrodes intravertebrally near the site of spinal cord injury and applying DC current at a level sufficient to induce regeneration and repair of damaged spinal axons but less than the current level at which tissue toxicity occurs.

A method of accessing target tissue adjacent to a spinal nerve of a patient includes the steps of accessing a spine location of the patient by entering the patient through the skin at an access location, inserting a flexible tissue modification device through the access location to the spine location, advancing a distal portion of the first flexible tissue modification device from the spine location to a first exit location, passing through the first exit location and out of the patient, advancing the first or a second flexible tissue modification device through the same access location to the spine location and to a second exit location, and passing through the second exit location and out of the patient.

A method and device for the insertion of a vertebral cage that may be done through a posterior approach that is minimally traumatic and does not require retraction of the spinal cord, dural sac or spinal nerves. The insertion of the cage may therefore be parallel to the spinal cord and the cage will be rotated ninety degrees (or as desired or required) in the vertebral body defect or as applicable to achieve its proper positioning before expansion.

A method of accessing target tissue adjacent to a spinal nerve of a patient includes the steps of accessing a spine location of the patient by entering the patient through the skin at an access location, inserting a flexible tissue modification device through the access location to the spine location, advancing a distal portion of the first flexible tissue modification device from the spine location to a first exit location, passing through the first exit location and out of the patient, advancing the first or a second flexible tissue modification device through the same access location to the spine location and to a second exit location, and passing through the second exit location and out of the patient.