Method for optimizing location of implanted electrode array during implant surgery

Abstract

A method for determining an effectual placement of an electrode array during a surgical procedure to implant the lead is provided. This method involves placing a lead having electrodes in a first location in a patient then (1) activating electrical stimulation to produce paresthesia, (2) “electronically trolling” the length of the electrode array and (3) determining whether the paresthesia is in an effective location. If the paresthesia is not in an effective location to match the location of the pain, the lead is moved to a different location steps (1) through (3) are repeated. The process of electronically trolling involves moving the electrical stimulation along the electrode array so that all regions of the electrode array provide stimulation. This method reduces or eliminates the need to move the lead during the implant procedure and thus simplifies the implant procedure compared to the currently used physical trolling method, reducing the risks to the patient. Additionally, this method saves time and improves outcomes by allowing multiple electrode combinations to be tested in a relatively short amount of time.

1 - 15 . (canceled)  
     
     
         16 . A method for determining an effectual placement of an electrode array during a surgical implant procedure comprising: 
 (a) placing a lead having electrodes in a first location in a patient;    (b) activating electrical stimulation to produce paresthesia;    (c) electronically trolling the length of said electrode array;    (d) determining whether the paresthesia is in an effective location;    (e) if the paresthesia is not in an effective location, moving the lead to a different location and repeating steps (b) through (d).    
     
     
         17 . The method according to  claim 16 , wherein the electrical stimulation is defined by parameters specified by software.  
     
     
         18 . The method according to  claim 17 , wherein the software comprises a steering table.  
     
     
         19 . The method according to  claim 18 , wherein the steering table comprises multiple rows containing stimulation parameters for one or more electrodes.  
     
     
         20 . The method according to  claim 19 , wherein the rows are arranged so that the electric field properties of adjacent rows in said steering table are similar.  
     
     
         21 . The method according to  claim 20 , wherein electronically trolling comprises: 
 moving the electrical stimulation from a first position on the electrode array to a second position on the electrode array.    
     
     
         22 . The method according to  claim 16 , wherein electronically trolling comprises: 
 electronically moving the electrical stimulation from a first position on the electrode array to a second position on the electrode array.    
     
     
         23 . A method for determining an effectual placement of an electrode array during a surgical implant procedure comprising: 
 (a) placing a lead having electrodes in a first location in a patient;    (b) providing electrical stimulation to produce paresthesia, the electrical stimulation defined by a first set of stimulation parameters specified by software;    (c) determining whether the paresthesia is in an effective location;    (d) providing electrical stimulation defined by a different set of stimulation parameters specified in software;    (e) determining whether the paresthesia is in an effective location;    (f) repeating steps (d) and (e) until effective paresthesia is obtained or all sets of stimulation parameters specified by software have been provided;    (g) if effective paresthesia is not obtained, moving the lead to a different location; and    (h) repeating steps (b) through (g) until effective paresthesia is obtained.    
     
     
         24 . The method according to  claim 23 , wherein the software comprises at least one steering table containing rows corresponding to sets of stimulation parameters.  
     
     
         25 . The method according to  claim 24 , wherein the rows are arranged so that the electric field properties of adjacent rows in said steering table are similar.  
     
     
         26 . The method according to  claim 23 , wherein the software comprises at least one algorithm specifying sets of stimulation parameters.  
     
     
         27 . The method according to  claim 23 , wherein repeating step (d) results in a gradual transition of stimulation from a first position on the electrode array to a second position on the electrode array.  
     
     
         28 . A method for determining an effectual placement of an electrode array for the treatment of pain comprising: 
 (a) placing a lead having electrodes in a first location in a patient;    (b) providing electrical stimulation to produce paresthesia, the electrical stimulation defined by a first set of stimulation parameters contained in a steering table;    (c) determining whether the location of the paresthesia effectively matches the location of the pain;    (d) if it does not, providing electrical stimulation defined by a different set of stimulation parameters contained in said steering table;    (e) repeating steps (c) and (d) until effective paresthesia is obtained or electrical stimulation defined by a representative number of sets of stimulation parameters has been provided;    (f) if the location of the paresthesia still does not effectively match the location of the pain, moving the lead to a different location; and    (g) repeating steps (b) through (f) until the location of the paresthesia effectively matches the location of the pain.    
     
     
         29 . The method according to  claim 28 , wherein the first set of stimulation parameters are contained in a first row of the steering table.  
     
     
         30 . The method according to  claim 28 , wherein the rows of the steering table are arranged so that the electric field properties of adjacent rows in said steering table are similar.  
     
     
         31 . The method according to  claim 28 , wherein providing electrical stimulation defined by a different set of stimulation parameters comprises: 
 providing electrical stimulation defined by stimulation parameters contained in an adjacent row of the steering table.    
     
     
         32 . The method according to  claim 31 , wherein the first row of the steering table contains stimulation parameters that define stimulation to be provided at a first end of the electrode array and the row of the steering table farthest from the first row contains stimulation parameters that define stimulation to be provided at a second end of the array.  
     
     
         33 . The method according to  claim 28 , wherein repeating step (d) results in a gradual transition of stimulation from a first position on the electrode array to a second position on the electrode array.  
     
     
         34 . The method according to  claim 33 , wherein repeating step (d) results in a gradual transition of stimulation from the first end of the electrode array to the second end of the electrode array.