Multiple tunable central cathodes on a paddle for increased medial-lateral and rostral-caudal flexibility via current steering
A neurostimulation paddle lead, method of neurostimulation, and neurostimulation system are provided. The neurostimulation paddle lead carries a plurality of electrodes comprising at least four columns of electrodes having a spacing between two inner electrode columns less than a spacing between the inner electrode columns and adjacent outer electrode columns. The inner electrode columns may also be longitudinally offset from the outer electrode columns. The methods and neurostimulation systems steer current between the electrodes to modify a medial-lateral electrical field created adjacent spinal cord tissue.
1. A method of providing therapy to a patient, comprising:
disposing at least four electrodes relatively far away from the spinal cord tissue of the patient in a medial-lateral electrode arrangement, wherein the at least four electrodes has two inner electrodes and two outer electrodes flanking the two inner electrodes;
configuring a first one of the inner electrodes as a cathode, a second one of the inner electrodes as an anode, and the outer electrodes as anodes;
conveying electrical energy between the cathodes and the anodes to create a medial-lateral electrical field that stimulates the spinal cord tissue;
reconfiguring the second one of the inner electrodes as a cathode; and
reconveying electrical energy between the cathodes and the anodes to create a medial-lateral electrical field that stimulates the spinal cord tissue.
2. The method of claim 1 , further comprising incrementally shifting cathodic current between the cathodes to modify the medial-lateral electrical field.
3. The method of claim 2 , further comprising incrementally shifting anodic current between the anodes to modify the medial-lateral electrical field.
4. The method of claim 2 , wherein the cathodic current is shifted in increments equal to or less than 10 percent.
5. The method of claim 1 , wherein the medial-lateral electrical field stimulates the dorsal column fibers without stimulating dorsal root fibers within the spinal cord tissue.
6. The method of claim 2 , wherein the cathodic current is incrementally shifted between the cathodes to spatially shift the medial-lateral electrical field transversely relative to dorsal column fibers of the spinal cord tissue.
7. The method of claim 1 , wherein a transverse spacing between the second one of the inner electrodes and the first one of the inner electrodes is less than a transverse spacing between a closest one of the outer electrodes and the second one of the inner electrodes.
8. The method of claim 1 , wherein the at least four electrodes are disposed within the epidural space of a patient.
9. A method of providing therapy to a patient, comprising:
disposing at least four electrodes relatively close to the spinal cord tissue of the patient in a medial-lateral electrode arrangement, wherein the at least four electrodes has two inner electrodes and two outer electrodes flanking the two inner electrodes;
configuring a first one of the inner electrodes as a cathode, a second one of the inner electrodes as a cathode, and the outer electrodes as anodes;
conveying electrical energy between the cathodes and the anodes to create a medial-lateral electrical field that stimulates the spinal cord tissue;
reconfiguring the second one of the inner electrodes as an anode; and
reconveying electrical energy between the cathodes and the anodes to create a medial-lateral electrical field that stimulates the spinal cord tissue.
10. The method of claim 9 , further comprising incrementally shifting cathodic current between the cathodes to modify the medial-lateral electrical field.
11. The method of claim 10 , further comprising incrementally shifting anodic current between the anodes to modify the medial-lateral electrical field.
12. The method of claim 10 , wherein the cathodic current is shifted in increments equal to or less than 10 percent.
13. The method of claim 9 , wherein the medial-lateral electrical field stimulates the dorsal column fibers without stimulating dorsal root fibers within the spinal cord tissue.
14. The method of claim 10 , wherein the cathodic current is incrementally shifted between the cathodes to spatially shift the medial-lateral electrical field transversely relative to dorsal column fibers of the spinal cord tissue.
15. The method of claim 9 , wherein a transverse spacing between the second one of the inner electrodes and the first one of the inner electrodes is less than a transverse spacing between a closest one of the outer electrodes and the second one of the inner electrodes.
16. The method of claim 9 , wherein the at least four electrodes are disposed within the epidural space of a patient.