The present invention is directed to the area of implantable electrical stimulation systems and methods of making and using the systems. The present invention is also directed to implantable electrical stimulation systems having coil connectors, as well as methods of making and using the coiled ring contacts and electrical stimulation systems.
Implantable electrical stimulation systems have proven therapeutic in a variety of diseases and disorders. For example, spinal cord stimulation systems have been used as a therapeutic modality for the treatment of chronic pain syndromes. Peripheral nerve stimulation has been used to treat chronic pain syndrome and incontinence, with a number of other applications under investigation. Functional electrical stimulation systems have been applied to restore some functionality to paralyzed extremities in spinal cord injury patients. Stimulation of the brain, such as deep brain stimulation, can be used to treat a variety of diseases or disorders.
Stimulators have been developed to provide therapy for a variety of treatments. A stimulator can include a control module (with a pulse generator), one or more leads, and an array of stimulator electrodes on each lead. The stimulator electrodes are in contact with or near the nerves, muscles, or other tissue to be stimulated. The pulse generator in the control module generates electrical pulses that are delivered by the electrodes to body tissue.
At least one aspect is a connector assembly that includes a connector body having an elongated shape with a first end, an opposing second end, and a longitudinal axis, the connector body defining a port at the first end configured to receive a proximal part of a lead or lead extension; and a plurality of coiled ring contacts axially spaced-apart within the connector body and collectively forming a lumen that extends from the port along the longitudinal axis of the connector body. Each coiled ring contact includes a contact housing including a first part and a second part attached to the first part, wherein at least the first part includes a first radial sidewall and a first lateral sidewall extending laterally from the first radial sidewall, the first radial sidewall and the first lateral sidewall defining a pocket, and a coiled ring disposed within the contact housing, wherein the coiled ring contact is configured for disposal of the coiled ring within the pocket defined by the first part of the contact housing and prior to attachment of the second part to the first part, wherein the coiled ring is positioned within the contact housing so that insertion of the proximal part of the lead or lead extension through the coiled ring contact results in contact between the coiled ring and the lead or lead extension.
In at least some aspects, the coiled ring is disposed within the pocket defined by the first part of the contact housing without deformation of the coiled ring. In at least some aspects, the coiled ring is disposed within the pocket defined by the first part of the contact housing without asymmetric deformation of the coiled ring.
In at least some aspects, the second part includes a second radial sidewall and a second lateral sidewall extending laterally from the second radial sidewall. In at least some aspects, the first lateral sidewall and the second lateral sidewall are attached to each other by ends thereof. In at least some aspects, the first lateral sidewall is disposed radially inward from the second lateral sidewall. In at least some aspects, the first part further includes a perimeter sidewall extending laterally from the first lateral sidewall, wherein the perimeter sidewall has a radial thickness that is less than a radial thickness of the first lateral sidewall, wherein at least a portion of the second lateral sidewall is disposed radially inward from the perimeter sidewall.
In at least some aspects, the first part further includes a first lateral tab extending laterally from the first lateral sidewall, wherein the perimeter sidewall has a radial thickness that is less than a radial thickness of the first lateral sidewall, wherein at least a portion of the second part is disposed radially inward from the first lateral tab. In at least some aspects, the second part is a flat disc having an opening therethrough.
In at least some aspects, the first and second parts define a groove within which at least a portion of the coiled ring is disposed, wherein the groove has at least a portion with a circular, semicircular, elliptical, or oval shape. In at least some aspects, the first and second parts define a groove within which at least a portion of the coiled ring is disposed, wherein the groove has at least a portion with a triangular shape. In at least some aspects, the first and second parts define a groove within which at least a portion of the coiled ring is disposed, wherein the groove has at least a portion with a square or rectangular shape.
Another aspect is a lead assembly that includes a lead or a lead extension having a proximal portion and a distal portion, wherein the proximal portion of the lead or the lead extension includes a plurality of terminals electrically insulated from one another; and any of the connector assemblies described above.
A further aspect is an electrical stimulating system that includes the lead assembly described above; and a control module coupled to the lead assembly, the control module including a housing, and an electronic subassembly disposed in the housing, wherein connector assembly is part of the control module.
Yet another aspect is an electrical stimulating system that includes the lead assembly described above; and a lead extension coupleable to the control module and the lead, wherein the connector assembly is part of the lead extension.
Another aspect is a coiled ring contact that includes a contact housing including a first part and a second part attached to the first part, wherein at least the first part includes a first radial sidewall and a first lateral sidewall extending laterally from the first radial sidewall, the first radial sidewall and the first lateral sidewall defining a pocket; and a coiled ring disposed within the contact housing, wherein the coiled ring contact is configured for disposal of the coiled ring within the pocket defined by the first part of the contact housing and prior to attachment of the second part to the first part, wherein the coiled ring is positioned within the contact housing so that insertion of a proximal part of a lead or lead extension through the coiled ring contact results in contact between the coiled ring and the lead or lead extension. Any of the aspects regarding the coiled ring contact presented above can be applied to this coiled ring contact.
A further aspect is a method of making any of the coiled ring contacts described above. The method includes disposing the coiled ring into the pocket defined by the first radial sidewall and the first lateral sidewall of the first part; and attaching the second part to the first part with the coiled ring disposed therebetween.
In at least some aspects, the second part includes a second radial sidewall and a second lateral sidewall extending laterally from the second radial sidewall, wherein attaching the second part to the first part includes attaching the first lateral sidewall to the second lateral sidewall by ends thereof. In at least some aspects, the second part is a flat disc having an opening there though. In at least some aspects, the second part includes a second radial sidewall and a second lateral sidewall extending laterally from the second radial sidewall, wherein the first lateral sidewall is disposed radially inward from the second lateral sidewall.
Non-limiting and non-exhaustive embodiments of the present invention are described with reference to the following drawings. In the drawings, like reference numerals refer to like parts throughout the various figures unless otherwise specified.
For a better understanding of the present invention, reference will be made to the following Detailed Description, which is to be read in association with the accompanying drawings, wherein:
The present invention is directed to the area of implantable electrical stimulation systems and methods of making and using the systems. The present invention is also directed to implantable electrical stimulation systems having coil connectors, as well as methods of making and using the coiled ring contacts and electrical stimulation systems.
Suitable implantable electrical stimulation systems include, but are not limited to, a least one lead with one or more electrodes disposed on a distal portion of the lead and one or more terminals disposed on one or more proximal portions of the lead. Leads include, for example, percutaneous leads, paddle leads, cuff leads, or any other arrangement of electrodes on a lead. Examples of electrical stimulation systems with leads are found in, for example, U.S. Pat. Nos. 6,181,969; 6,516,227; 6,609,029; 6,609,032; 6,741,892; 7,244,150; 7,450,997; 7,672,734; 7,761,165; 7,783,359; 7,792,590; 7,809,446; 7,949,395; 7,974,706; 8,175,710; 8,224,450; 8,271,094; 8,295,944; 8,364,278; 8,391,985; and 8,688,235; and U.S. Patent Applications Publication Nos. 2007/0150036; 2009/0187222; 2009/0276021; 2010/0076535; 2010/0268298; 2011/0005069; 2011/0004267; 2011/0078900; 2011/0130817; 2011/0130818; 2011/0238129; 2011/0313500; 2012/0016378; 2012/0046710; 2012/0071949; 2012/0165911; 2012/0197375; 2012/0203316; 2012/0203320; 2012/0203321; 2012/0316615; 2013/0105071; and 2013/0197602, all of which are incorporated by reference. In the discussion below, a percutaneous lead will be exemplified, but it will be understood that the methods and systems described herein are also applicable to paddle leads and other leads.
A percutaneous lead for electrical stimulation (for example, deep brain, spinal cord, peripheral nerve, or cardiac-tissue stimulation) includes stimulation electrodes that can be ring electrodes, segmented electrodes that extend only partially around the circumference of the lead, or any other type of electrode, or any combination thereof. The segmented electrodes can be provided in sets of electrodes, with each set having electrodes circumferentially distributed about the lead at a particular longitudinal position. A set of segmented electrodes can include any suitable number of electrodes including, for example, two, three, four, or more electrodes. For illustrative purposes, the leads are described herein relative to use for deep brain stimulation, but it will be understood that any of the leads can be used for applications other than deep brain stimulation, including spinal cord stimulation, peripheral nerve stimulation, dorsal root ganglion stimulation, sacral nerve stimulation, or stimulation of other nerves, muscles, and tissues.
Turning to
The IPG 14 is physically connected, optionally, via one or more lead extensions 24, to the stimulation lead(s) 12. Each lead carries multiple electrodes 26 arranged in an array. The IPG 14 includes pulse generation circuitry that delivers electrical stimulation energy in the form of, for example, a pulsed electrical waveform (i.e., a temporal series of electrical pulses) to the electrode array 26 in accordance with a set of stimulation parameters. The implantable pulse generator can be implanted into a patient's body, for example, below the patient's clavicle area or within the patient's buttocks or abdominal cavity. The implantable pulse generator can have eight stimulation channels which may be independently programmable to control the magnitude of the current stimulus from each channel. In some embodiments, the implantable pulse generator can have more or fewer than eight stimulation channels (e.g., 4-, 6-, 16-, 32-, or more stimulation channels). The implantable pulse generator can have one, two, three, four, or more connector ports, for receiving the terminals of the leads and/or lead extensions.
The ETS 20 may also be physically connected, optionally via the percutaneous lead extensions 28 and external cable 30, to the stimulation leads 12. The ETS 20, which may have similar pulse generation circuitry as the IPG 14, also delivers electrical stimulation energy in the form of, for example, a pulsed electrical waveform to the electrode array 26 in accordance with a set of stimulation parameters. One difference between the ETS 20 and the IPG 14 is that the ETS 20 is often a non-implantable device that is used on a trial basis after the neurostimulation leads 12 have been implanted and prior to implantation of the IPG 14, to test the responsiveness of the stimulation that is to be provided. Any functions described herein with respect to the IPG 14 can likewise be performed with respect to the ETS 20.
The RC 16 may be used to telemetrically communicate with or control the IPG 14 or ETS 20 via a uni- or bi-directional wireless communications link 32. Once the IPG 14 and neurostimulation leads 12 are implanted, the RC 16 may be used to telemetrically communicate with or control the IPG 14 via a uni- or bi-directional communications link 34. Such communication or control allows the IPG 14 to be turned on or off and to be programmed with different stimulation parameter sets. The IPG 14 may also be operated to modify the programmed stimulation parameters to actively control the characteristics of the electrical stimulation energy output by the IPG 14. The CP 18 allows a user, such as a clinician, the ability to program stimulation parameters for the IPG 14 and ETS 20 in the operating room and in follow-up sessions. Alternately, or additionally, stimulation parameters can be programed via wireless communications (e.g., Bluetooth) between the RC 16 (or external device such as a hand-held electronic device) and the IPG 14.
The CP 18 may perform this function by indirectly communicating with the IPG 14 or ETS 20, through the RC 16, via a wireless communications link 36. Alternatively, the CP 18 may directly communicate with the IPG 14 or ETS 20 via a wireless communications link (not shown). The stimulation parameters provided by the CP 18 are also used to program the RC 16, so that the stimulation parameters can be subsequently modified by operation of the RC 16 in a stand-alone mode (i.e., without the assistance of the CP 18).
For purposes of brevity, the details of the RC 16, CP 18, ETS 20, and external charger 22 will not be further described herein. Details of exemplary embodiments of these devices are disclosed in U.S. Pat. No. 6,895,280, which is expressly incorporated herein by reference. Other examples of electrical stimulation systems can be found at U.S. Pat. Nos. 6,181,969; 6,516,227; 6,609,029; 6,609,032; 6,741,892; 7,949,395; 7,244,150; 7,672,734; and 7,761,165; 7,974,706; 8,175,710; 8,224,450; and 8,364,278; and U.S. Patent Application Publication No. 2007/0150036, as well as the other references cited above, all of which are incorporated by reference.
Turning to
Percutaneous leads are described herein for clarity of illustration. It will be understood that paddle leads and cuff leads can be used in lieu of, or in addition to, percutaneous leads. The leads described herein include 8 electrodes. It will be understood that the leads could include any suitable number of electrodes. The leads described herein exclusively include ring electrodes. It will be understood that the leads can include a distal-tip electrode, or one or more segmented electrodes in lieu of, or in addition to one or more ring electrodes. Additionally, the term “elongated member” used herein includes leads (e.g., percutaneous, paddle, cuff, or the like), as well as intermediary devices (e.g., lead extensions, adaptors, splitters, or the like).
Conductors can extend along the longitudinal length of the lead within one or more lumens defined in the lead. In other instances, the conductors may extend along the lead within the lead body itself. The lead 212 includes an retention sleeve 208 disposed along the proximal portion of the body to facilitate coupling of the proximal portion of the lead to a connector. The connector may be disposed along a control module. Alternatively, the retention sleeve 208 can be used to facilitate coupling of the proximal portion of the lead to a connector of an intermediary device, such as a lead extension which, in turn, is coupled to a connector of a control module.
The lead-extension connector 390 contains a lead-extension connector stack 365 that defines a connector lumen 367 configured to receive the proximal portion of an elongated member (e.g., lead 212). The lead-extension connector stack 365 includes lead-extension connector contacts, such as lead-extension connector contact 369, arranged along the connector lumen 367 and configured to electrically couple with terminals of the elongated member (e.g., lead 212) when the proximal portion of the elongated member is received by the lead-extension connector 390. The connector contacts are electrically isolated from one another by electrically-nonconductive spacers, such as spacer 371. In at least some embodiments, the spacers provide at least a partial seal to reduce, or even eliminate, seepage of fluid into the connector from the environment external to the connector. The connector stack may also include an end stop 373 to promote alignment of the elongated-member terminals with the lead-extension connector contacts.
The lead-extension connector 390 further includes a retention assembly for facilitating retention of the proximal portion of the elongated member (e.g., lead 212) when the proximal portion of the elongated member is received by the lead-extension connector 390. In the illustrated embodiment, the retention assembly includes a lead-extension retention block 392. The lead-extension retention block 392 is positioned to align with the retention sleeve (208 in
Lead-extension conductors, such as lead-extension conductor 331, extend along a longitudinal length of the lead extension and electrically couple the lead-extension connector contacts to the array of lead-extension terminals 327. The lead-extension conductors can extend along the longitudinal length of the lead-extension body within one or more lumens defined in the lead extension. In other instances, the lead-extension conductors may extend along the lead extension within the lead-extension body itself. The lead extension 312 includes a retention sleeve 308 disposed along the proximal portion of the lead-extension body to facilitate coupling of the proximal portion of the lead extension to a connector, such as a control-module connector, another lead-extension connector, or the like.
The housing further includes an unsealed portion that includes a connector 590 configured to receive an elongated device (e.g., the lead 212, the lead extension 312, or other intermediary device). Optionally, the connector 590 is positioned along an outer surface of the sealed portion of the housing. The connector 590 contains a connector stack 565 that defines a connector lumen 567 configured to receive the proximal portion of the elongated member. The connector stack 565 includes an array of connector contacts, such as connector contact 569, arranged along the connector lumen 567 and configured to electrically couple with terminals of the elongated member when the proximal portion of the elongated member is received by the connector 590. The connector contacts are electrically isolated from one another by electrically-nonconductive spacers, such as spacer 571. The connector stack may also include an end stop 573 to promote alignment of the elongated-member terminals with the connector contacts.
Feedthrough interconnects, such as feedthrough interconnect 582, are electrically coupled to the electrical subassembly 558 and extend within the sealed portion of the housing to a feedthrough interface 586 disposed along an interface between the sealed and unsealed portions of the housing. The connector contacts are electrically coupled to interconnect wires, such as interconnect wire 580, that extend along the unsealed portion of the housing and electrically couple the connector contacts to the feedthrough interconnects at the feedthrough interface 586. In some embodiments, the connector 590 is positioned along an outer surface of the sealed housing over the feedthrough interface 586. In other embodiments, the connector 590 is disposed at least partially within an outer surface of the sealed housing.
The connector 590 further includes a retention assembly for facilitating retention of the proximal portion of the elongated member when the proximal portion of the elongated member is received by the control module 552. In the illustrated embodiment, the retention assembly includes a retention block 592. The retention block 592 is positioned to align with the retention sleeve (208 in
One example of a connector contact (e.g., connector contact 369 or 569) that can be used in a control module or a lead extension is a coiled ring contact. A coiled ring contact (e.g., canted coil contact) includes a conductive coiled ring (e.g., canted coil) disposed in a conductive contact housing. The coiled ring can be deformed or damaged during conventional methods for assembly of the coiled ring contact. In at least some embodiments, the coiled ring is a garter spring, which is a coiled spring that is connected at each end, or continuous, creating a ring shape. Examples of coiled ring contacts 730 are presented in
In contrast to these conventional coiled ring contacts, a coiled ring contact can include a contact housing that can be manufactured in at least two parts. One of the parts forms a pocket into which the coiled ring can be placed and then the second part is attached to the first part to retain the coiled ring in the contact housing.
In the embodiment of
The coiled ring 732 and the contact housing 734 can be formed of any suitable material including, but not limited to, stainless steel, titanium, platinum, or the like or any combination thereof, such as stainless steel coated with titanium or platinum. The first and second parts 736, 738 can be formed by any suitable method including, but not limited to, stamping, machining, molding, or the like or any combination thereof. The first and second parts 736, 738 can be formed using the same method or different methods.
Any suitable method can be used to attach the second part 738 of the contact housing 734 to the first part 736 including, but not limited to, laser welding, resist welding, TIG (tungsten inert gas) welding, MIG (metal inert gas) welding, other welding techniques, or the like or any combination thereof. The attachment may include one or more spot attachments (e.g., spot welding), one or more seam attachments (e.g., seam welding), or the like or any combination thereof.
In addition to the first radial sidewall 740a and first lateral sidewall 742a, the first part 736 also includes a perimeter sidewall 748 extending from the first lateral sidewall 742a. The embodiments of
The radial thickness (e.g., the largest thickness in the radial direction) of the perimeter sidewall 748 is less than the radial thickness of the first lateral sidewall 742a. In at least some embodiments, the radial thickness of the perimeter sidewall 748 is no more than 75, 67, 60, 50, 40, 33, 25, or 20% of the thickness of the first lateral sidewall 742a.
The perimeter sidewall 748 surrounds at least a portion of the second part 738, as illustrated in
In the embodiments of
In the embodiment of
The first and second parts 736, 738 of the contact housing 734 define a groove 750.
Some of the components (for example, a power source 1612, an antenna 1618, a receiver 1602, and a processor 1604) of the electrical stimulation system can be positioned on one or more circuit boards or similar carriers within a sealed housing of an implantable pulse generator, if desired. Any power source 1612 can be used including, for example, a battery such as a primary battery or a rechargeable battery. Examples of other power sources include super capacitors, nuclear or atomic batteries, mechanical resonators, infrared collectors, thermally-powered energy sources, flexural powered energy sources, bioenergy power sources, fuel cells, bioelectric cells, osmotic pressure pumps, and the like including the power sources described in U.S. Pat. No. 7,437,193, incorporated herein by reference.
As another alternative, power can be supplied by an external power source through inductive coupling via the optional antenna 1618 or a secondary antenna. The external power source can be in a device that is mounted on the skin of the user or in a unit that is provided near the user on a permanent or periodic basis.
If the power source 1612 is a rechargeable battery, the battery may be recharged using the optional antenna 1618, if desired. Power can be provided to the battery for recharging by inductively coupling the battery through the antenna to a recharging unit 1616 external to the user. Examples of such arrangements can be found in the references identified above.
In one embodiment, electrical current is emitted by the electrodes 26 on the paddle or lead body to stimulate nerve fibers, muscle fibers, or other body tissues near the electrical stimulation system. The processor 1604 is generally included to control the timing and electrical characteristics of the electrical stimulation system. For example, the processor 1604 can, if desired, control one or more of the timing, frequency, strength, duration, and waveform of the pulses. In addition, the processor 1604 can select which electrodes can be used to provide stimulation, if desired. In some embodiments, the processor 1604 selects which electrode(s) are cathodes and which electrode(s) are anodes. In some embodiments, the processor 1604 is used to identify which electrodes provide the most useful stimulation of the desired tissue.
Any processor can be used and can be as simple as an electronic device that, for example, produces pulses at a regular interval or the processor can be capable of receiving and interpreting instructions from an external programming unit 1608 that, for example, allows modification of pulse characteristics. In the illustrated embodiment, the processor 1604 is coupled to a receiver 1602 which, in turn, is coupled to the optional antenna 1618. This allows the processor 1604 to receive instructions from an external source to, for example, direct the pulse characteristics and the selection of electrodes, if desired.
In one embodiment, the antenna 1618 is capable of receiving signals (e.g., RF signals) from an external telemetry unit 1606 which is programmed by the programming unit 1608. The programming unit 1608 can be external to, or part of, the telemetry unit 1606. The telemetry unit 1606 can be a device that is worn on the skin of the user or can be carried by the user and can have a form similar to a pager, cellular phone, or remote control, if desired. As another alternative, the telemetry unit 1606 may not be worn or carried by the user but may only be available at a home station or at a clinician's office. The programming unit 1608 can be any unit that can provide information to the telemetry unit 1606 for transmission to the electrical stimulation system 1600. The programming unit 1608 can be part of the telemetry unit 1606 or can provide signals or information to the telemetry unit 1606 via a wireless or wired connection. One example of a suitable programming unit is a computer operated by the user or clinician to send signals to the telemetry unit 1606.
The signals sent to the processor 1604 via the antenna 1618 and the receiver 1602 can be used to modify or otherwise direct the operation of the electrical stimulation system. For example, the signals may be used to modify the pulses of the electrical stimulation system such as modifying one or more of pulse duration, pulse frequency, pulse waveform, and pulse strength. The signals may also direct the electrical stimulation system 1600 to cease operation, to start operation, to start charging the battery, or to stop charging the battery. In other embodiments, the stimulation system does not include the antenna 1618 or receiver 1602 and the processor 1604 operates as programmed.
Optionally, the electrical stimulation system 1600 may include a transmitter (not shown) coupled to the processor 1604 and the antenna 1618 for transmitting signals back to the telemetry unit 1606 or another unit capable of receiving the signals. For example, the electrical stimulation system 1600 may transmit signals indicating whether the electrical stimulation system 1600 is operating properly or not or indicating when the battery needs to be charged or the level of charge remaining in the battery. The processor 804 may also be capable of transmitting information about the pulse characteristics so that a user or clinician can determine or verify the characteristics.
The above specification provides a description of the structure, manufacture, and use of the invention. Since many embodiments of the invention can be made without departing from the spirit and scope of the invention, the invention also resides in the claims hereinafter appended.
This application claims the benefit under 35 U.S.C. § 119 (e) of U.S. Provisional Patent Application Ser. No. 63/538,241, filed Sep. 13, 2024, which is incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 63538241 | Sep 2023 | US |