Patent Application
20090157183
The present invention relates to a method for treating disorders of the spine using electrical stimulation.
Complaints related to the spine make up a significant portion of annual visits to health care providers and lost productivity. Current treatments include both surgical and non-surgical means. Surgical treatments include common procedures such as laminectomy, discectomy, spinal fusions, and more recently disc and nucleus replacement. Non-surgical treatments include physical therapy, medications, and injections.
Unfortunately, non-surgical treatments are time consuming, do not often work, and must be repeated indefinitely. Surgical treatments can be more effective but only a small portion of patients with spine problems qualify for spinal surgery.
One of the most common problems of the spine is low back pain. It is unclear often times where the pain is coming from and what is causing it and unfortunately many patients simply have to suffer with this problem.
One treatment for spinal problems that has been around for some time is called spinal cord stimulation. This involves the placement of a configuration of simple electrical contacts spaced along an electrode or wire which is connected to battery powered electronics (or a pulse generator). The electronics send out continuous or intermittent signals to one or more of these electrical contacts to modulate pain related to the spine. Typically, this procedure works best for pain in the extremity but can also work for pain along the spinal axis.
The procedure involves either open or percutaneous placement of the electrodes in the dorsal epidural space usually in the cervical or thoracic spine. Although the exact mechanism of action is unknown, it may work by blocking pain signals from getting to the brain.
The method of the present invention proposes to treat complaints related to the spine by applying stimulating electrodes to the disc itself (rather than placing them in the epidural space) as that can be a source of pain.
One technology that is superficially similar but distinctly different is radiofrequency ablation (e.g. Sharkey et al, U.S. Pat. No. 7,282,061). In this technique, an electrode is placed into the disc space and a radiofrequency generator is used to provide energy to the tip of the electrode which is placed into the disc space. The electrode is not implanted and the purpose of the applied energy is to burn or heat the disc to shrink it or destroy any pain fibers. The method of the present invention does not aim to heat or destroy the disc material and rather than permanently destroying any pain fibers, the method of the present invention aims to merely modulate or mask the pain from the disc or otherwise influence the disc material non-destructively.
While the invention has been shown and described with reference to certain preferred embodiments, it will be understood by those skilled in the art that various changes and modifications in form and detail may be made therein without departing from the spirit and scope of the invention, as defined by the appended claims.
It is an objective of the present invention to provide a novel method of treating spinal complaints using commercially available electrodes.
It is an objective of the present invention to provide a method of placing one or more electrodes into the disc space itself via a trocar.
It is an objective of the present invention to provide a means of treating common spinal complaints including but not limited to: neck pain, back pain, lumbago, cervicalgia, spondylosis, annular tear, degenerative disc disease, degenerative joint disease, herniated disc, disc bulge, “black disc”, etc.
It is an objective of the present invention to describe a device comprising an electrode with electrical contacts which is placed into the disc space incorporating a feature to help retain the electrode within the disc space.
Variations in electrode design and configuration are possible. Multiple electrical contacts can be spaced along a single electrode and multiple electrodes can be used. The preferred embodiment involves placing the electrodes from a posterolateral approach into the disc space from either a unilateral or bilateral approach utilizing a cannulated trocar. Other methods of placement can include simple open surgical placement, placement from a direct lateral or direct anterior approach.
As an example only, with no intention of limitation of scope, the following is given as a possible sequence of events:
Use of the device and the means of treating spinal disorders would then involve programming of various parameters including frequency, amplitude, timing, and determining which electrodes to use.
Alternatively, another embodiment of the present invention might involve placement of a self contained device which fits entirely within the disc space and delivers the electrical current via charge stored in a battery or some form of capacitor. Recharging of the device could come from either an external inductance coil or via a mechanism within the disc space which generates electricity for storage via movement of the spine and/or changes in pressure in the disc space.
