Methods for stimulating a dorsal root ganglion
View Patent ↗Some embodiments of the present invention provide stimulation systems and components for selective stimulation and/or neuromodulation of one or more dorsal root ganglia through implantation of an electrode on, in or around a dorsal root ganglia. Some other embodiments of the present invention provide methods for selective neurostimulation of one or more dorsal root ganglia as well as techniques for applying neurostimulation to the spinal cord. Still other embodiments of the present invention provide stimulation systems and components for selective stimulation and/or neuromodulation of one or more dorsal root ganglia through implantation of an electrode on, in or around a dorsal root ganglia in combination with a pharmacological agent.
1. A method of stimulating at least two dorsal root ganglia, comprising:
implanting the first electrode on a first spinal level in, on or adjacent a first dorsal root ganglion;
implanting the second electrode in, on or adjacent a second dorsal root ganglion;
connecting the first and second electrodes to a common signal generator; and
activating the first electrode to selectively stimulate the first dorsal root ganglion.
2. The method of claim 1 , wherein the second electrode is on a second spinal level.
3. The method of claim 2 , wherein the first and second spinal levels are adjacent to each other.
4. The method of claim 1 , wherein the second electrode is on the first spinal level.
5. The method of claim 1 , further comprising implanting a third electrode in, on or adjacent a third dorsal root ganglion.
6. The method of claim 1 , further comprising advancing the first electrode toward the dorsal root ganglion by a lateral approach.
7. The method of claim 1 , wherein activating comprises providing stimulation energy to the first electrode, wherein the stimulation energy has an energy below a threshold for stimulating a first ventral root associated with the first dorsal root ganglion.
8. The method of claim 1 , wherein activating comprises providing stimulation energy to the first electrode, wherein the stimulation energy has an energy which only stimulates neural tissue within the first dorsal root ganglion.
9. The method of claim 1 , wherein activating comprises providing stimulation energy to the first electrode, wherein the stimulation energy preferentially stimulates myelinated, large diameter fibers over unmyelinated, small diameter fibers.
10. The method of claim 1 , wherein the first spinal level is a lumbar spinal level.
11. The method of claim 10 , wherein the first and second dorsal root ganglions are located on the same or different lumbar spinal levels.
12. The method of claim 10 , wherein the portion of the spinal cord comprises a cuneate fascicle, a gracile fascicle, a corticospinal tract, an ascending neural pathway, and/or a descending neural pathway.
13. The method of claim 1 , wherein the first spinal level is a thoracic spinal level.
14. The method of claim 13 , wherein the first and second dorsal root ganglions are located on the same or different thoracic spinal levels.
15. The method of claim 13 , wherein the second electrode is on a second spinal level, and wherein the second spinal level is a cervical, lumbar or sacral spinal level.
16. The method of claim 1 , wherein the first spinal level is a sacral spinal level.
17. The method of claim 16 , wherein the second electrode is on a second spinal level which is not a sacral spinal level.
18. The method of claim 1 , wherein the first spinal level is a cervical spinal level.
19. The method of claim 1 , further comprising implanting a third electrode within an epidural space so as to stimulate a portion of a spinal cord other than a spinal nerve.
20. The method of claim 1 , further comprising implanting a third electrode in contact with a portion of the sympathetic nervous system.