Dorsal Nerve Root Stimulation Electrode Selection
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Solution Overview
Problem
Current spinal cord lateral stimulation techniques for treating focal pain are inefficient, as they often fail to provide desired coverage and can result in stimulation spill-over or over-stimulation, requiring complex surgical procedures and specialized training.
Innovation Solution
The system employs leads with multiple electrodes to deliver targeted dorsal root modulation by determining a therapeutic window for each electrode, allowing for selective stimulation of sensory fibers in the dorsal root to treat focal pain while avoiding undesirable effects on motor fibers or other neural tissues.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If epidural mid line leads are used for lateral stimulation, then the surgical procedure is simple and does not require specialized training, but the coverage of focal pain area is insufficient and stimulation spill over occurs
Solution Approach 1:
The patent applies local quality by using multiple electrodes positioned at different locations along the spinal cord to provide localized stimulation to specific focal pain areas. Each electrode can be independently controlled to deliver stimulation to a specific segment, enabling precise targeting of pain regions while avoiding unnecessary stimulation of adjacent areas. This resolves the contradiction by maintaining surgical simplicity while achieving precise pain area coverage through selective electrode activation.
2Manufacturing precision
If epidural leads are placed to target the dorsal root ganglion, then good focal pain coverage is achieved, but the surgical procedure becomes more complex and requires specialized training
Solution Approach 1:
The patent applies segmentation by dividing the spinal cord stimulation into multiple independent electrode segments along the longitudinal axis. This allows the system to achieve precise focal pain coverage by activating only the specific electrode segments corresponding to the pain area, while maintaining a relatively simple surgical procedure compared to direct DRG targeting. The segmented electrode array enables precise targeting without requiring the complex steering and positioning needed for traditional DRG approaches.
3Manufacturing precision
If peripheral nerve stimulation is used, then good focal pain coverage is achieved, but the surgical procedure is more complex and motor axon stimulation is more likely to occur
Solution Approach 1:
The patent applies the taking out principle by extracting and isolating the dorsal root sensory fibers from the mixed spinal nerve that contains both sensory and motor fibers. By positioning electrodes to selectively stimulate only the dorsal root sensory components while avoiding the ventral motor roots, the system achieves precise focal pain coverage without causing unwanted motor fiber stimulation. This separation allows independent control of sensory and motor nerve components.
4Manufacturing precision
If a small therapeutic window for DRG stimulation is used, then focal pain coverage is achieved, but over stimulation occurs
Solution Approach 1:
The patent applies dynamics by implementing adjustable and programmable stimulation parameters for each electrode, allowing the therapeutic window to be dynamically optimized for each patient and pain condition. The system can adapt stimulation amplitude, pulse width, and frequency parameters to achieve effective pain relief while avoiding over-stimulation. This dynamic control enables precise dosing of neural stimulation to match individual patient thresholds and prevent harmful over-stimulation effects.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach provides more effective lateral stimulation of the spinal cord, offering improved pain coverage with reduced risk of stimulation spill-over and over-stimulation, thus enhancing treatment efficacy and patient comfort.
Implementation Method 1
The stimulation waveform generator may be configured to deliver neurostimulation through any one of the plurality of electrodes
Data Source
AI summary
A system may include at least one lead, a stimulation waveform generator, and a controller. The controller may be programmed to implement a process to suggest at least one electrode to be used to stimulate the nerve root. A therapeutic window may be determined for each electrode. For each electrode determining the therapeutic window may include applying stimulation, determining a first stimulation threshold for the applied stimulation to cause a first physiological effect, determining a second stimulation threshold for the applied stimulation to cause a second physiological effect, and determining a difference between the first stimulation threshold and the second stimulation threshold, wherein the difference is the therapeutic window. The process may further include determining at electrode(s) with a minimum value for the therapeutic window, and suggesting the electrode(s) to be used to stimulate the nerve root based on the determined electrode(s) with the minimum value.