Angled Spinal Cord Lead Placement for Midline Identification
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Solution Overview
Problem
Current spinal cord stimulation techniques for pain relief are inefficient due to the inaccurate placement of electrodes, as the physiological midline often differs from the anatomical midline, leading to time-consuming and unreliable procedures that require patients to be awake during testing under anesthesia.
Innovation Solution
Implanting leads at an angle of 5-20 degrees relative to the anatomical midline of the spinal cord, allowing for electrodes to be placed on both sides of the physiological midline, and using a user interface to determine the optimal electrode combination post-surgery based on patient feedback, eliminating the need for in-room testing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If leads are placed parallel to the anatomical midline of the spinal cord, then the implantation procedure is simple and straightforward, but the electrodes may not be accurately positioned relative to the physiological midline, resulting in ineffective pain relief
Solution Approach 1:
The patent applies asymmetry by placing leads at an angled orientation (e.g., 15-30 degrees) relative to the anatomical midline rather than parallel to it. This asymmetric placement strategy ensures that electrodes are distributed on both sides of the physiological midline, which is offset from the anatomical midline, thereby achieving accurate positioning while maintaining procedural simplicity
Solution Approach 2:
The patent introduces an angular dimension to the lead placement procedure. Instead of placing leads in a single dimension (parallel to the anatomical midline), the leads are positioned at an angle in a second dimension, creating a more effective spatial distribution of electrodes relative to the physiological midline
2Productivity
If electrode combinations are tested in the operating room with the patient under anesthesia, then the procedure can be completed immediately, but the patient feedback is unreliable due to disorientation from anesthesia
Solution Approach 1:
The patent applies preliminary action by performing lead implantation and positioning before patient feedback is required. Leads are implanted at an angled orientation that pre-positions electrodes on both sides of the physiological midline, so that when the patient wakes from anesthesia, the correct electrode combinations can be identified without needing to wake the patient during the procedure
Solution Approach 2:
The patent uses feedback by obtaining patient responses after they have fully awakened from anesthesia. The system presents different electrode combinations to the awake patient and records their feedback on pain relief and paresthesia, ensuring reliable feedback is obtained when the patient is mentally alert and oriented
3Measurement precision
If multiple electrode combinations are tested to identify the optimal configuration, then accurate pain relief can be achieved, but the procedure becomes time-consuming and costly
Solution Approach 1:
The patent applies preliminary action by pre-positioning leads at an angled orientation that ensures electrodes are distributed on both sides of the physiological midline. This preliminary strategic placement reduces the number of electrode combinations that need to be tested, as the correct combinations are more likely to be identified quickly when electrodes are properly distributed
Solution Approach 2:
The asymmetric angular placement of leads creates an optimal geometric distribution of electrodes that facilitates faster identification of effective combinations. By positioning leads at an angle rather than parallel to the anatomical midline, the system increases the probability that certain electrode combinations will effectively target the physiological midline region
Data Source
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AI summary
Techniques for delivery of electrical neurostimulation therapy to a patient are disclosed. In one example, a processor controls delivery of electrical neurostimulation therapy to a patient by an electrical neurostimulation therapy device and via a plurality of combinations of a plurality of electrodes disposed along a lead inserted across an anatomical midline of a spinal cord of the patient and angled relative to the anatomical midline, the lead connected to the electrical neurostimulation therapy device. The processor determines, based on the electrical neurostimulation therapy, a location of a physiological midline of the spinal cord. The processor selects, based on the location of the physiological midline, at least one electrode of the plurality of electrodes for subsequent delivery of electrical neurostimulation therapy to the patient. Further, the processor displays a representation of the physiological midline and the anatomical midline relative to the spinal cord.