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 leads having a threaded connector assembly, as well as methods of making and using the connector assembly and the 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.
In one embodiment, a connector assembly includes a lead having a lead body having a proximal portion and a distal portion. The lead body defines a longitudinal axis. The lead further includes terminals disposed along the proximal portion of the lead body and a proximal tip attached to the proximal portion of the lead body. The proximal tip defines an aperture that is non-parallel to the longitudinal axis of the lead body. The connector assembly further includes a connector having a connector body, a connector lumen, and connector contacts disposed within the connector body and adjacent the connector lumen. The connector body includes a fastener aperture proximal to all of the connector contacts and intersecting the connector lumen. The fastener aperture of the connector and aperture of the proximal tip of the lead are configured and arranged for alignment when the proximal portion of the lead body is fully received within the connector lumen. Either one or both of the aperture of the proximal tip of the lead or the fastener aperture of the connector includes internal threading. The connector assembly further includes a threaded fastener configured and arranged for insertion into the aperture of the proximal tip of the lead and the fastener aperture of the connector. The threaded fastener engages the internal threading to fasten, couple or otherwise secure the lead to the connector.
In at least some embodiments, the aperture of the proximal tip of the lead extends completely through the proximal tip.
In at least some embodiments, the connector assembly further includes an end stop disposed within the connector body and positioned to halt the insertion of the lead into the connector. The end stop can be made from a material that is more rigid than a material of the lead body.
In at least some embodiments, the aperture of the proximal tip is orthogonal to the longitudinal axis of the lead body. In at least some embodiments, an internal diameter of the fastener aperture is equal to an internal diameter of the aperture of the proximal tip of the lead.
In at least some embodiments, the fastener aperture is fully threaded. In at least some embodiments, the aperture of the proximal tip of the lead is fully threaded. In at least some embodiments, the threaded fastener is fully threaded along an outer surface of the threaded fastener.
In at least some embodiments, after insertion of the threaded fastener, a first end portion of the threaded fastener is in contact with an end stop disposed within the connector body and a second, opposing end portion of the threaded fastener extends out of an outer periphery of the end stop.
In at least some embodiments, after insertion of the threaded fastener, a first end portion of the threaded fastener is in contact with an end stop disposed within the connector body and a second, opposing end portion of the threaded fastener seated below an outer periphery of the end stop.
In at least some embodiments, an interface between the threaded fastener and the proximal tip provides a fluid resistant seal. In at least some embodiments, the threaded fastener may be a set screw. In at least some embodiments, a receiving portion of the proximal tip is countersunk.
In a further embodiment, an electrical stimulation system includes the connector assembly having the lead and the connector described above and a control module. The control module is coupleable to the electrical stimulation lead. The control module includes a housing and an electronic subassembly disposed in the housing.
In at least some embodiments, the electrical stimulation system further includes a lead extension coupleable to both the connector assembly and the control module.
In another embodiment, a lead includes a lead body and a proximal tip. The lead body includes a proximal portion and a distal portion. The lead body defines a longitudinal axis. The lead further includes a plurality of terminals disposed along the proximal portion of the lead body. The proximal tip is attached to the proximal portion of the lead body. The proximal tip defines an aperture that is non-parallel to the longitudinal axis of the lead body. At least a portion of an internal surface of the aperture is internally threaded for engagement with an externally threaded fastener.
In at least some embodiments, the internal surface of the aperture is fully threaded along a length of the aperture.
In yet another embodiment, a connector includes a connector body defining a connector lumen; and a plurality of connector contacts disposed within the connector body adjacent to the connector lumen. The connector body includes a fastener aperture located proximal to all of the connector contacts and intersecting the connector lumen. At least a portion of an internal surface of the fastener aperture is internally threaded for engagement with an externally threaded fastener.
In at least some embodiments, the connector further includes an end stop disposed within the connector body and positioned to halt the insertion of a proximal tip of a lead into the connector.
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 leads having a threaded connector assembly, as well as methods of making and using the leads 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 along a distal end of the lead and one or more terminals disposed along the one or more proximal ends of the lead.
Leads include, for example, percutaneous leads, paddle leads, and cuff leads. Examples of electrical stimulation systems with leads are found in, for example, U.S. Pat. Nos. 6,181,969; 6,295,944; 6,391,985; 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; 8,831,742; 8,688,235; 6,175,710; 6,224,450; 6,271,094; 6,295,944; 6,364,278; and 6,391,985; U.S. Patent Applications Publication Nos. 2007/0150036; 2009/0187222; 2009/0276021; 2010/0076535; 2010/0268298; 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; 2011/0005069; 2010/0268298; 2011/0130817; 2011/0130818; 2011/0078900; 2011/0238129; 2011/0313500; 2012/0016378; 2012/0046710; 2012/0165911; 2012/0197375; 2012/0203316; 2012/0203320; and 2012/0203321, all of which are incorporated by reference in their entireties.
Examples of connector assemblies for electrical stimulation systems with leads are found in, for example, U.S. Pat. Nos. 8,849,396; 7,244,150; 8,600,507; 8,897,876; 8,682,439; U.S. Patent Applications Publication Nos. 2012/0053646; 2014/0148885; 2015/0209575; 2016/0059019; and U.S. Patent Provisional Patent Application Nos. 62/193,472; 62/216,594; 62/259,463; and 62/278,667, all of which are incorporated by reference in their entireties.
It will be understood that the electrical stimulation system can include more, fewer, or different components and can have a variety of different configurations including those configurations disclosed in the electrical stimulation system references cited herein. For example, instead of a paddle body, the electrodes can be disposed in an array at or near the distal end of a lead body forming a percutaneous lead.
The lead 103 can be coupled to the control module 102 in any suitable manner. In
In
With reference to
The electrical stimulation system or components of the electrical stimulation system, including the paddle body 104, the one or more of the lead bodies 106, and the control module 102, are typically implanted into the body of a patient. The electrical stimulation system can be used for a variety of applications including, but not limited to deep brain stimulation, neural stimulation, spinal cord stimulation, muscle stimulation, and the like.
The electrodes 134 can be formed using any conductive, biocompatible material. Examples of suitable materials include metals, alloys, conductive polymers, conductive carbon, and the like, as well as combinations thereof. In at least some embodiments, one or more of the electrodes 134 are formed from one or more of: platinum, platinum iridium, palladium, palladium rhodium, or titanium.
Any suitable number of electrodes 134 can be disposed on the lead including, for example, four, five, six, seven, eight, nine, ten, eleven, twelve, fourteen, sixteen, twenty-four, thirty-two, or more electrodes 134. In the case of paddle leads, the electrodes 134 can be disposed on the paddle body 104 in any suitable arrangement. In
The electrodes of the paddle body 104 (or one or more lead bodies 106) are typically disposed in, or separated by, a non-conductive, biocompatible material such as, for example, silicone, polyurethane, polyetheretherketone (“PEEK”), epoxy, and the like or combinations thereof. The one or more lead bodies 106 and, if applicable, the paddle body 104 may be formed in the desired shape by any process including, for example, molding (including injection molding), casting, and the like. The non-conductive material typically extends from the distal ends of the one or more lead bodies 106 to the proximal end of each of the one or more lead bodies 106.
In the case of paddle leads, the non-conductive material typically extends from the paddle body 104 to the proximal end of each of the one or more lead bodies 106. Additionally, the non-conductive, biocompatible material of the paddle body 104 and the one or more lead bodies 106 may be the same or different. Moreover, the paddle body 104 and the one or more lead bodies 106 may be a unitary structure or can be formed as two separate structures that are permanently or detachably coupled together.
Terminals (e.g., 310 in
The electrically conductive wires (“conductors”) may be embedded in the non-conductive material of the lead body 106 or can be disposed in one or more lumens (not shown) extending along the lead body 106. In some embodiments, there is an individual lumen for each conductor. In other embodiments, two or more conductors extend through a lumen. There may also be one or more lumens (not shown) that open at, or near, the proximal end of the one or more lead bodies 106, for example, for inserting a stylet to facilitate placement of the one or more lead bodies 106 within a body of a patient. Additionally, there may be one or more lumens (not shown) that open at, or near, the distal end of the one or more lead bodies 106, for example, for infusion of drugs or medication into the site of implantation of the one or more lead bodies 106. In at least one embodiment, the one or more lumens are flushed continually, or on a regular basis, with saline, epidural fluid, or the like. In at least some embodiments, the one or more lumens are permanently or removably sealable at the distal end.
The control module connector 144 defines at least one port into which a proximal end of the elongated device 300 can be inserted, as shown by directional arrows 312a and 312b. In
The control module connector 144 also includes a plurality of connector contacts, such as connector contact 314, disposed within each port 304a and 304b. When the elongated device 300 is inserted into the ports 304a and 304b, the connector contacts 314 can be aligned with a plurality of terminals 310 disposed along the proximal end(s) of the elongated device(s) 300 to electrically couple the control module 102 to the electrodes (134 of
A lead extension connector 322 is disposed on the lead extension 324. In
In at least some embodiments, the proximal end of the lead extension 324 is similarly configured and arranged as a proximal end of the lead 103 (or other elongated device 300). The lead extension 324 may include a plurality of electrically conductive wires (not shown) that electrically couple the connector contacts 340 to a proximal end 348 of the lead extension 324 that is opposite to the distal end 326. In at least some embodiments, the conductive wires disposed in the lead extension 324 can be electrically coupled to a plurality of terminals (not shown) disposed along the proximal end 348 of the lead extension 324. In at least some embodiments, the proximal end 348 of the lead extension 324 is configured and arranged for insertion into a connector disposed in another lead extension (or another intermediate device). In other embodiments (and as shown in
Coupling a neuromodulation lead to a receptacle is generally accomplished using a conventional system that includes a set block and set screw mechanism. The conventional system may have a relatively large lateral profile (e.g., a spatial envelope as defined radially outward from a longitudinal axis of the lead) as compared to a lateral profile of the lead. In some clinical applications, for example, it may be preferred to have a smaller or reduced lateral profile for the lead and receptacle interface, as compared to the conventional system, to enhance patient comfort and provide clinical efficacy.
In at least some embodiments of the present invention, an alternative connector assembly utilizes a lead and a connector, which may be part of a lead extension, for example. The lead includes a proximal tip having a threaded proximal tip aperture that is non-parallel to a longitudinal axis of the lead or lead lumen, and preferably perpendicular or orthogonal to a longitudinal axis of the lead or lead lumen. The connector includes a fastener aperture that can be aligned with the proximal tip aperture. A threaded fastener, which may take the form of a set screw or threaded pin, is insertable into the proximal tip aperture and into the fastener aperture to affix or otherwise secure the lead to the connector while achieving a low or reduced lateral profile of the overall connector assembly.
The terminals of the proximal array 402 are typically disposed in, or separated by, a non-conductive, biocompatible material such as, for example, silicone, polyurethane, polyetheretherketone (“PEEK”), epoxy, and the like or combinations thereof. The terminals themselves can be formed using any conductive, biocompatible material. Examples of suitable materials include metals, alloys, conductive polymers, conductive carbon, and the like, as well as combinations thereof. In at least some embodiments, one or more of the terminals are formed from one or more of: platinum, platinum iridium, palladium, palladium rhodium, or titanium.
The proximal tip 404 may be made from a variety of materials such as, but not limited to, the same material as the proximal array 402 (e.g., the lead body or a material that is more rigid than the proximal array 402). By way of example, a more rigid material may take the form of a metallic, composite or plastic material. The proximal tip 404 may also be referred to as a connector set block or “in-lead” block.
In at least some embodiments, the proximal tip aperture 406 functions as an opening to receive the threaded fastener, which will be described in more detail with respect to
For purposes of the description herein, the connector 500 includes the end stop 506 embedded within the connector body 502. However, and at least in some embodiments, the connector 500 may not include the end stop and the various openings and other features associated with the end stop 506 could be applied directly and solely to the connector body 502.
In the illustrated embodiment, the end stop 506 is located at a proximal end of the connector 500. In at least some embodiments, the end stop 506 may be made from a variety of materials such as, but not limited to, the same material as the connector body 502 or a material that is more rigid than the connector body 502. By way of example, a more rigid material may take the form of a metallic, composite or plastic material.
In at least some embodiments, a fastener aperture 508 extends through at least a portion of the connector body 502 and a portion of the end stop 506. In other embodiments, the fastener aperture 508 extends completely through at least one of the connector body 502, the end stop 506, or both. The connector body 502 defines a connector axis 510 (
Referring specifically to
In at least some embodiments, the fastener aperture 508 is not threaded, the proximal tip aperture 406 is threaded, and the threaded fastener 514 includes threads that coincide with the threaded proximal tip aperture 406. In an alternate embodiment, the fastener aperture 508 is threaded, the proximal tip aperture 406 is not threaded, and the threaded fastener 514 includes threads that coincide with the threaded fastener aperture 508. It is appreciated that if the fastener aperture 508 is threaded, but the proximal tip aperture 406 is not threaded, then the threaded fastener 514 is preferably made long enough to engage and remain engaged with the fastener aperture 508 threads even when the threaded fastener is fully seated.
In at least some embodiments, the internal diameter of the fastener apertures 508 is equal to an internal diameter of the proximal tip aperture 406. If either of the apertures 508, 406 is threaded, for purposes of comparing the internal diameters of the apertures, the internal diameter of a threaded aperture is the diameter measured between threads (e.g., the largest diameter of the aperture or the diameter of the aperture in absence of the threading).
Some of the components (for example, a power source 812, an antenna 818, a receiver 802, and a processor 804) 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 812 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 818 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 812 is a rechargeable battery, the battery may be recharged using the optional antenna 818, if desired. Power can be provided to the battery for recharging by inductively coupling the battery through the antenna to a recharging unit 816 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 134 on the paddle or lead body to stimulate nerve fibers, muscle fibers, or other body tissues near the electrical stimulation system. The processor 804 is generally included to control the timing and electrical characteristics of the electrical stimulation system. For example, the processor 804 can, if desired, control one or more of the timing, frequency, strength, duration, and waveform of the pulses. In addition, the processor 804 can select which electrodes can be used to provide stimulation, if desired. In some embodiments, the processor 804 selects which electrode(s) are cathodes and which electrode(s) are anodes. In some embodiments, the processor 804 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 808 that, for example, allows modification of pulse characteristics. In the illustrated embodiment, the processor 804 is coupled to a receiver 802 which, in turn, is coupled to the optional antenna 818. This allows the processor 804 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 818 is capable of receiving signals (e.g., RF signals) from an external telemetry unit 806 which is programmed by the programming unit 808. The programming unit 808 can be external to, or part of, the telemetry unit 806. The telemetry unit 806 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 806 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 808 can be any unit that can provide information to the telemetry unit 806 for transmission to the electrical stimulation system 800. The programming unit 808 can be part of the telemetry unit 806 or can provide signals or information to the telemetry unit 806 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 806.
The signals sent to the processor 804 via the antenna 818 and the receiver 802 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 800 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 818 or receiver 802 and the processor 804 operates as programmed.
Optionally, the electrical stimulation system 800 may include a transmitter (not shown) coupled to the processor 804 and the antenna 818 for transmitting signals back to the telemetry unit 806 or another unit capable of receiving the signals. For example, the electrical stimulation system 800 may transmit signals indicating whether the electrical stimulation system 800 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. 62/360,145, filed Jul. 8, 2016, which is incorporated herein by reference.
Number | Date | Country | |
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62360145 | Jul 2016 | US |