SYSTEMS AND METHODS FOR GEL-BASED NEUROMODULATION
Methods, devices and systems are described for gel-based modulation of neural tissue, including prevention of nerve regeneration and neuroma formation. The gel can be delivered to selected target locations within or proximate nerves, including interfascicularly and intrafascicularly. Gel delivery associated with an operative procedure for the treatment of pain and other indications is also disclosed.
1 . A method of preventing nerve regeneration and neuroma formation in a patient, comprising:
providing a composition comprising a hydrolytically degradable bond-containing hydrogel;
identifying a target region associated with a nerve;
injecting the composition into the target region; and
contacting the nerve with the composition to form a barrier to confine neurite outgrowth from the nerve.
2 . The method of claim 1 , wherein the target region comprises an epidural space.
3 . The method of claim 1 , wherein the nerve is a damaged nerve.
4 . The method of claim 1 , wherein the hydrogel is adherent to the nerve for a period of 3 months or more.
5 . The method of claim 1 , wherein following injecting the hydrogel into the target region, the hydrogel swells to a volume greater than a volume injected to compress the nerve.
6 . The method of claim 1 , wherein the hydrogel is a blank hydrogel.
7 . The method of claim 1 , wherein the hydrogel is in situ forming.
8 . The method of claim 1 , wherein the hydrogel comprises one of: PEG-ester, PEG-NHS ester, or hyaluronic acid.
9 . The method of claim 1 , wherein the hydrogel has a compressive strength from 0 to 10 kPa or 20 kPa.
10 . The method of claim 1 , wherein the hydrogel a tensile strength from 10 to 15 kPa or 20 kPa.
11 . The method of claim 1 , wherein the composition further comprises a therapeutic agent.
12 . The method of claim 11 , wherein the therapeutic agent comprises resiniferatoxin (RTX).
13 . A method of modulating a nerve of a patient, comprising:
providing a composition comprising a hydrolytically degradable bond-containing hydrogel;
identifying a target region associated with the nerve;
injecting the composition into the target region; and
contacting the nerve with the composition to form a barrier to confine neurite outgrowth from the nerve and prevent neuroma formation in the nerve.
14 . The method of claim 13 , wherein the target region comprises an epidural space.
15 . The method of claim 13 , wherein the nerve is a damaged nerve.
16 . The method of claim 13 , further comprising:
identifying the target region associated with the nerve under imaging guidance; and
injecting the composition into the target region to contact the nerve perineurally.
17 . The method of claim 13 , wherein following injecting the hydrogel into the target region, the hydrogel swells to a volume greater than a volume injected to compress the nerve.
18 . The method of claim 13 , wherein the hydrogel is a blank hydrogel.
19 . The method of claim 13 , wherein the hydrogel is in situ forming.
20 . The method of claim 13 , wherein the hydrogel comprises one of: PEG-ester, PEG-NHS ester, or hyaluronic acid.
21 . The method of claim 13 , wherein the hydrogel has a compressive strength from 0 to 10 kPa or 20 kPa.
22 . The method of claim 13 , wherein the hydrogel a tensile strength from 10 to 15 kPa or 20 kPa.
23 . The method of claim 13 , wherein the composition further comprises a therapeutic agent.
24 . The method of claim 23 , wherein the therapeutic agent comprises resiniferatoxin (RTX).