Technique for Minimally Invasive, Stimulation Guided Placement of Spiral Coil Electrode
Publication Date: 2003-Sep-09
The IP.com Prior Art Database
Kristen N. Jaax: INVENTOR [+4]
A technique for minimally invasive, stimulation guided placement of a lead with a spiral coil electrode includes implanting the spiral electrode on a lead for stimulation of peripheral nerves using a surgical placement tool for the lead which allows manipulation of the spiral electrode during implantation and test stimulation of the nerve prior to placement of the lead.
Stimulation Guided Placement of Spiral Coil Electrode
Background & Summary
Over the past several decades, nerve stimulation has proven to be an effective method for treating a variety of disorders. Deep Brain Stimulation has demonstrated success in controlling the symptoms of movement disorders such as Parkinson’s disease. Stimulation of the dorsal columns of the spinal cord relieves the symptoms of chronic pain and has been demonstrated to attenuate the severity of angina pectoris, not only raising the exercise threshold for anginal pain, but also improving perfusion in ischemic regions of the heart. Recent studies have also demonstrated efficacy of peripheral nerve stimulation in treating disease including chronic pain, urinary incontinence and epilepsy.
Successful application of electrical stimulation requires that the electrode be consistently maintained in close proximity to the stimulation target. A nonleaded microstimulation system such as the bion®, by Advanced Bionics® Corporation is well suited for many applications. On occasion, though, circumstances may require the use of a lead attached to a remote implantable pulse generator (IPG) to achieve consistent stimulation of a particular nerve target. The anatomy of the region may make local placement of even a small (IPG) untenable. Also, in some locations scar tissue formation following IPG implantation may make future device replacements necessitated by finite battery lifespan prohibitively difficult. Finally, the physiology of certain stimulation targets, e.g. nonmyelinated nerves, may demand a specialized electrode design to achieve stimulation.
The spiral coil electrode is a specialized electrode design which offers unique advantages. First, because a spiral coil electrode may be wrapped fully around the circumference of the nerve, the electrode is able to create a highly localized field around the nerve. A highly localized field results in a strong stimulating field while minimizing the power output required from the IPG. Second, because the ring created around the nerve is not complete, the helical design minimizes the risk seen with complete nerve cuffs in which swelling of the nerve can result in nerve compression injury.
Current methods for electrode implantation often require open procedures in which the surgeon makes a wide incision in the skin, dissects the tissue to visualize the nerve, and then manually manipulates the electrode to wrap it around the nerve. This process has a number of disadvantages. First, the size of the incision and the dissection process results in scar tissue formation which can complicate future reimplantation procedures. Second, risk of device infection is amplified not only by performing an open procedure but also by the need for the surgeon to manually handle the electrode during the implantation procedure. Third and finally, the scar produced by the large incision is aesthetically unappealing to the patient...