Spinal Cord Stimulation Midline Localization via Peripheral EMG Feedback
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Solution Overview
Problem
Current spinal cord stimulation therapies face challenges in determining effective stimulation parameters due to uncertainties in electrode placement and the anatomical alignment of neuroanatomy, which limits the customization and effectiveness of treatment for chronic pain management.
Innovation Solution
A technique that uses peripheral electrodes in conjunction with spinal electrodes to measure and calculate the relative position of spinal electrodes to a physiological midline, allowing for the precise determination of the physiological midline location and optimizing electrode placement for improved stimulation therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional spinal cord stimulation therapy is used with standard electrode placement, then the treatment can be administered, but the effectiveness is limited due to uncertainties in electrode placement and anatomical alignment
Solution Approach 1:
The patent replaces mechanical/anatomical landmark-based electrode placement with a physiological signal-based method. By using EMG signals from peripheral muscles as a reference, the system substitutes the mechanical alignment process with an electrophysiological measurement approach, allowing precise identification of the physiological midline without relying on anatomical landmarks.
Solution Approach 2:
The system employs feedback by continuously monitoring EMG signals from peripheral muscles and using this information to determine the relative position of spinal electrodes to the physiological midline. The measured EMG signal amplitudes provide feedback that is processed to calculate electrode positioning accuracy, enabling real-time assessment and adjustment of electrode placement.
2Ease of operation
If anatomical landmarks are used to determine midline for electrode placement, then the procedure is simple, but the alignment with physiological midline is inaccurate
Solution Approach 1:
The patent introduces EMG signals from peripheral muscles as an intermediary reference to bridge the gap between simple anatomical landmarks and precise physiological midline. The EMG signals serve as a mediator that translates easily obtainable peripheral measurements into accurate information about spinal electrode positioning relative to the physiological midline.
Solution Approach 2:
The system transitions from two-dimensional anatomical surface landmarks to a functional physiological dimension by using EMG signal amplitudes. This adds a functional layer of measurement that correlates peripheral muscle activity with central spinal cord electrode positioning, enabling more accurate midline identification.
Data Source
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AI summary
Techniques for determining the location of a physiological midline are disclosed. A first technique evaluates the response to stimulation of spinal electrodes at peripheral electrodes on different sides of the body. In this technique, a spinal electrode's position relative to a physiological midline is determined based on a relationship between responses to its stimulation observed on different sides of the body. A second technique evaluates the response of spinal electrodes to stimulation of peripheral electrodes on different sides of the body. In this technique, a spinal electrode's position relative to a physiological midline is determined based on the different responses that it observes to stimulation on different sides of the body.