Selective high frequency spinal cord modulation for inhibiting pain with reduced side effects, and associated systems and methods
View Patent ↗Selective high-frequency spinal cord modulation for inhibiting pain with reduced side effects and associated systems and methods are disclosed. In particular embodiments, high-frequency modulation in the range of from about 1.5 KHz to about 50 KHz may be applied to the patient's spinal cord region to address low back pain without creating unwanted sensory and/or motor side effects. In other embodiments, modulation in accordance with similar parameters can be applied to other spinal or peripheral locations to address other indications.
1. A method for at least partially alleviating pain in a patient without using paresthesia to mask the patient's sensation of pain, comprising:
identifying a patient with a spinal modulation system having (i) an implantable signal delivery device, and (ii) a signal generator electrically coupled to the implantable signal delivery device;
programming the signal generator to
(a) generate a non-paresthesia producing therapy signal, wherein the therapy signal includes a plurality of sequential biphasic pulses with pulse widths between 25 microseconds and 166 microseconds, and
(b) deliver the therapy signal to a location at the patient's spinal cord, via the implantable signal delivery device.
2. The method of claim 1 , wherein at least a portion of the therapy signal is a bi-phasic square-wave.
3. The method of claim 2 , further comprising:
programming the signal generator to generate the therapy signal with at least a portion of the therapy signal having a frequency of 10 kHz.
4. The method of claim 3 , further comprising:
programming the signal generator to apply the therapy signal at a duty cycle.
5. The method of claim 1 , wherein at least a portion of the therapy signal is at a frequency in a frequency range from 3 kHz to 20 kHz.
6. The method of claim 1 , wherein the pulse widths are in a range from 30 microseconds to 35 microseconds.
7. The method of claim 1 , wherein the current amplitude is in a range from 0.1 mA to 20 mA.
8. The method of claim 1 , wherein the current amplitude is in a range from 0.5 mA to 10 mA.
9. The method of claim 1 , wherein the implantable signal delivery device is a percutaneous lead having two or more electrodes implanted proximate to the location in the patient's spinal cord.
10. The method of claim 1 , wherein the programming is performed without the patient reporting whether or not
(1) pain reduction is achieved while in an operating room, or
(2) a sensation of paresthesia at least partially masks the sensation of pain, or
(3) both (1) and (2).
11. A method for treating a patient, comprising:
identifying a patient with back and/or leg pain and a spinal cord modulator associated with the patient, wherein a lead of the spinal cord modulator is configured for placement in an epidural space; and
using an external programmer to configure the spinal cord modulator to generate and deliver a non-paresthesia producing therapy signal to the patient's spinal cord, wherein the therapy signal includes a plurality of sequential biphasic square-wave pulses with pulse widths between 25 microseconds and 166 microseconds.
12. The method of claim 11 , wherein at least a portion of the therapy signal is at a frequency in a frequency range from 3 kHz to 20 kHz.
13. The method of claim 11 , wherein at least a portion of the therapy signal is at a frequency of 10 kHz.
14. The method of claim 11 , wherein the pulse widths are between 30 microseconds and 35 microseconds.
15. The method of claim 11 , wherein the amplitude is in a range from 0.1 mA to 20 mA.
16. The method of claim 11 , wherein the amplitude is in a range from 0.5 mA to 10 mA.
17. The method of claim 11 , wherein the therapy signal is delivered to a target location in the patient's spinal cord at a thoracic vertebral level.
18. The method of claim 11 , wherein the therapy signal is delivered to a target location in the patient's spinal cord at a vertebral level between T9 and T10, inclusive, and the therapy signal at least partially reduces a sensation of pain in the patient's lower back and/or leg.
19. A method for configuring a patient treatment system, comprising:
identifying a patient with back and/or leg pain and an epidural spinal cord modulator, wherein a lead of the spinal cord modulator is configured for placement in an epidural space of the patient; and
using an external programmer to configure a non-paresthesia producing therapy signal for the epidural spinal cord modulator, wherein the therapy signal is
(i) a biphasic square-wave signal,
(ii) at a frequency in a frequency range from 3 kHz to 20 kHz,
(iii) with a pulse width in a pulse width range from 25 microseconds to 166 microseconds, and
(iv) at a current amplitude in a current amplitude range from 0.1 mA to 20 mA.
20. The method of claim 19 , wherein the pulse width range is from 30 microseconds to 35 microseconds.
21. The method of claim 19 , wherein the therapy signal is delivered to the patient's spinal cord at a vertebral level between T9 and T12, inclusive.
22. The method of claim 21 , wherein the frequency range is from 5 kHz to 15 kHz.
23. The method of claim 22 , further comprising:
using the external programmer to configure the therapy signal to be delivered at a duty cycle.
24. The method of claim 20 , wherein at least a portion of the therapy signal is at a frequency of 10 kHz.
25. The method of claim 19 , wherein the therapy signal at a current amplitude that at least partially reduces the patient's sensation of pain without affecting neural transmissions of touch or heat.