JP2010512185A - 脊髄刺激のための集合リード - Google Patents
脊髄刺激のための集合リード Download PDFInfo
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- 210000000278 spinal cord Anatomy 0.000 title claims abstract description 38
- 230000000638 stimulation Effects 0.000 title description 34
- 210000003594 spinal ganglia Anatomy 0.000 claims abstract description 73
- 238000000034 method Methods 0.000 claims abstract description 34
- 210000000273 spinal nerve root Anatomy 0.000 claims abstract description 12
- 230000004936 stimulating effect Effects 0.000 claims abstract description 11
- 208000003098 Ganglion Cysts Diseases 0.000 claims description 4
- 208000005400 Synovial Cyst Diseases 0.000 claims description 4
- 210000005036 nerve Anatomy 0.000 claims description 4
- 230000003014 reinforcing effect Effects 0.000 claims description 3
- 230000001788 irregular Effects 0.000 claims description 2
- 230000001537 neural effect Effects 0.000 abstract description 6
- 210000001519 tissue Anatomy 0.000 description 18
- 208000002193 Pain Diseases 0.000 description 10
- 230000036407 pain Effects 0.000 description 10
- 210000000944 nerve tissue Anatomy 0.000 description 7
- 210000004126 nerve fiber Anatomy 0.000 description 5
- 210000001175 cerebrospinal fluid Anatomy 0.000 description 4
- 230000035807 sensation Effects 0.000 description 4
- 101150083710 DRG3 gene Proteins 0.000 description 3
- 102100028945 Developmentally-regulated GTP-binding protein 1 Human genes 0.000 description 3
- 102100037711 Developmentally-regulated GTP-binding protein 2 Human genes 0.000 description 3
- 101000838507 Homo sapiens Developmentally-regulated GTP-binding protein 1 Proteins 0.000 description 3
- 101000880940 Homo sapiens Developmentally-regulated GTP-binding protein 2 Proteins 0.000 description 3
- 101000979748 Homo sapiens Protein NDRG1 Proteins 0.000 description 3
- 210000001951 dura mater Anatomy 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 230000002349 favourable effect Effects 0.000 description 3
- 238000007726 management method Methods 0.000 description 3
- 230000001174 ascending effect Effects 0.000 description 2
- 210000000988 bone and bone Anatomy 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 238000002684 laminectomy Methods 0.000 description 2
- 210000000653 nervous system Anatomy 0.000 description 2
- 210000000578 peripheral nerve Anatomy 0.000 description 2
- 230000001953 sensory effect Effects 0.000 description 2
- 210000001032 spinal nerve Anatomy 0.000 description 2
- 238000002054 transplantation Methods 0.000 description 2
- 206010001497 Agitation Diseases 0.000 description 1
- 208000008035 Back Pain Diseases 0.000 description 1
- 240000006829 Ficus sundaica Species 0.000 description 1
- 206010033425 Pain in extremity Diseases 0.000 description 1
- 206010033799 Paralysis Diseases 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 210000001217 buttock Anatomy 0.000 description 1
- 238000004590 computer program Methods 0.000 description 1
- 230000005684 electric field Effects 0.000 description 1
- 230000005284 excitation Effects 0.000 description 1
- 229920005570 flexible polymer Polymers 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 230000007794 irritation Effects 0.000 description 1
- 238000002690 local anesthesia Methods 0.000 description 1
- 210000004705 lumbosacral region Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 230000007433 nerve pathway Effects 0.000 description 1
- 230000007935 neutral effect Effects 0.000 description 1
- 231100000862 numbness Toxicity 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 238000012827 research and development Methods 0.000 description 1
- 229920002379 silicone rubber Polymers 0.000 description 1
- 239000004945 silicone rubber Substances 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0551—Spinal or peripheral nerve electrodes
- A61N1/0553—Paddle shaped electrodes, e.g. for laminotomy
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- Health & Medical Sciences (AREA)
- Neurology (AREA)
- Neurosurgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Electrotherapy Devices (AREA)
Abstract
Description
本願は、2006年12月6日付けで出願された米国仮特許出願第60/873,464号(弁護士整理番号No.10088-706.101)を基礎とする優先権を主張するものであり、すべての目的において参考にここに一体に統合される。
適用なし。
適用なし。
Claims (22)
- 複数の後根神経節を刺激する方法であって、
長手方向軸を有し、これに沿って配置された少なくとも2つの電極を含むリードを硬膜上腔内に配置するステップと、
選択的に刺激を与えることができるように、少なくとも2つの電極のそれぞれが複数の後根神経節のうちの1つの距離の範囲内に配置されるようにリードを位置合わせするステップと、
複数の後根神経節のうちの少なくとも1つを選択的に刺激するようにリードに電気的なエネルギを供給するステップとを有することを特徴とする方法。 - 請求項1に記載の方法であって、
電気的なエネルギを供給するステップは、互いに隣接しない少なくとも2つの後根神経節に選択的に刺激を与えるようにリードに電気的なエネルギを供給するステップを含むことを特徴とする方法。 - 請求項1に記載の方法であって、
少なくとも2つの電極は、長手方向軸に沿って配置された一連の電極を含み、
リードに電気的なエネルギを供給するステップは、一連の電極のうちの個別の電極であって、上記距離の範囲内に配置され、関連する後根神経節を選択的に刺激することができる個別の電極を選択的に電気的なエネルギを供給するステップを含むことを特徴とする方法。 - 請求項1に記載の方法であって、
個別の電極間の距離のいくつかが不規則であることを特徴とする方法。 - 体の組織内の神経を刺激するための伸縮自在のリードであって、
近位端、遠位端、およびこれらの間のルーメンを有し、表面上に少なくとも1つの電極を有する長い管状本体部と、
近位端、遠位端、および表面上に少なくとも1つの電極を有する内側構造体とを備え、
内側構造体は、その遠位端が長い管状本体部の遠位端を越えて延びるようにルーメン内を移動することができ、
内側構造体は、リードが組織内を押し進められるよう十分な強度を有するように、近位端および遠位端の間に延びる強化部材を有することを特徴とするリード。 - 請求項5に記載のリードであって、
内側構造体は、ルーメン内での回転を防止するような形状を有することを特徴とするリード。 - 請求項5に記載のリードであって、
管状本体部は、楕円形または長方形のルーメンを有することを特徴とするリード。 - 請求項5に記載のリードであって、
少なくとも1つの電極は、実質的に長手方向に位置合わせされていることを特徴とするリード。 - 請求項5に記載のリードであって、
内側構造体は、孔を貫通するような寸法を有することを特徴とするリード。 - 請求項5に記載のリードであって、
複数の電極は独立してエネルギ供給することが可能であることを特徴とするリード。 - 請求項5に記載のリードであって、
近位端、遠位端、およびこれらの間のルーメンを有し、表面上に少なくとも1つの電極を有する追加的な長い管状本体部をさらに備え、
追加的な長い管状本体部は、前記長い管状本体部のルーメン内を移動できるように構成され、
内側構造体は、追加的な長い管状本体部のルーメン内を移動することができることを特徴とするリード。 - 請求項11に記載のリードであって、
少なくとも1つの電極は、実質的に長手方向に位置合わせされていることを特徴とするリード。 - 請求項5に記載のリードであって、
長い管状本体部および内側構造体は、長い管状本体部上の少なくとも1つの電極が第1の後根神経節に位置合わせされる一方、内側構造体上の少なくとも1つの電極が第2の後根神経節に位置合わせされるように移動可能であることを特徴とするリード。 - 請求項5に記載のリードであって、
長い管状本体部および内側構造体は、長い管状本体部上の少なくとも1つの電極が後根神経節の第1部分に位置合わせされる一方、内側構造体上の少なくとも1つの電極が後根神経節の第2部分に位置合わせされるように移動可能であることを特徴とするリード。 - 少なくとも1つの後根神経節を刺激する方法であって、
伸縮自在のリードを後根神経節に向かって移動させるステップを有し、
前記リードは、
近位端、遠位端、およびこれらの間のルーメンを有し、表面上に少なくとも1つの電極を有する長い管状本体部と、
表面上に少なくとも1つの電極を有する内側構造体であって、その遠位端が長い管状本体部の遠位端を越えて延びるようにルーメン内を移動することができる内側構造体とを有し、
後根神経節に刺激を与えるために、少なくとも1つの電極を後根神経節の付近に配置するステップをさらに有することを特徴とする方法。 - 請求項15に記載の方法であって、
伸縮自在のリードを移動させるステップは、少なくとも部分的に孔を貫通するようにリードを移動させるステップを含むことを特徴とする方法。 - 請求項15に記載の方法であって、
伸縮自在のリードを移動させるステップは、脊柱の外部から水平方向に後根神経節に接近させるステップを含むことを特徴とする方法。 - 請求項15に記載の方法であって、
電極を配置するステップは、後根神経節に隣接する内側構造体上の少なくとも1つの電極を後根神経節の付近に配置するために、内側構造体を伸張または収縮させるステップを含むことを特徴とする方法。 - 請求項15に記載の方法であって、
伸縮自在のリードを移動させるステップは、伸縮自在のリードが硬膜上腔を貫通するように移動させるステップを含むことを特徴とする方法。 - 請求項19に記載の方法であって、
電極を配置するステップは、内側構造体上の少なくとも1つの電極を後根神経節に隣接して配置させ、管状本体部上の少なくとも1つの電極を別の後根神経節に隣接して配置させるように、内側構造体を移動させるステップを含むことを特徴とする方法。 - 請求項20に記載の方法であって、
後根神経節および別の後根神経節は隣接する脊髄レベル上にあることを特徴とする方法。 - 請求項19に記載の方法であって、
後根神経節および他の後根神経節は、互いに隣接する脊髄レベルにはないことを特徴とする方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US87346406P | 2006-12-06 | 2006-12-06 | |
US60/873,464 | 2006-12-06 | ||
PCT/US2007/086693 WO2008070804A2 (en) | 2006-12-06 | 2007-12-06 | Grouped leads for spinal stimulation |
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JP2013166689A Division JP5759519B2 (ja) | 2006-12-06 | 2013-08-09 | 脊髄刺激のための集合リード |
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JP2010512185A true JP2010512185A (ja) | 2010-04-22 |
JP2010512185A5 JP2010512185A5 (ja) | 2011-01-20 |
JP5433420B2 JP5433420B2 (ja) | 2014-03-05 |
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JP2013166689A Active JP5759519B2 (ja) | 2006-12-06 | 2013-08-09 | 脊髄刺激のための集合リード |
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US (1) | US20080147156A1 (ja) |
EP (1) | EP2094350B1 (ja) |
JP (2) | JP5433420B2 (ja) |
CN (1) | CN101588839A (ja) |
AU (1) | AU2007329250B2 (ja) |
CA (1) | CA2671575A1 (ja) |
WO (1) | WO2008070804A2 (ja) |
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JP2012506759A (ja) * | 2008-10-27 | 2012-03-22 | スパイナル・モデュレーション・インコーポレイテッド | 選択的刺激システムおよび医学的状態の信号パラメータ |
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JP2012521801A (ja) * | 2009-03-24 | 2012-09-20 | スパイナル・モデュレーション・インコーポレイテッド | 錯感覚に対する閾値以下の刺激を伴う疼痛の管理 |
JP2021523778A (ja) * | 2018-05-11 | 2021-09-09 | シナーヒューズ・インコーポレイテッドSynerfuse, Inc. | 脊椎安定化と神経調節とを組み合わせるシステム、デバイス、および方法 |
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Publication number | Publication date |
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EP2094350A4 (en) | 2010-07-14 |
JP5759519B2 (ja) | 2015-08-05 |
JP2013240710A (ja) | 2013-12-05 |
EP2094350A2 (en) | 2009-09-02 |
CA2671575A1 (en) | 2008-06-12 |
JP5433420B2 (ja) | 2014-03-05 |
AU2007329250A1 (en) | 2008-06-12 |
CN101588839A (zh) | 2009-11-25 |
US20080147156A1 (en) | 2008-06-19 |
WO2008070804A2 (en) | 2008-06-12 |
AU2007329250B2 (en) | 2012-03-15 |
WO2008070804A3 (en) | 2008-09-25 |
EP2094350B1 (en) | 2018-06-13 |
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