Method of neurostimulation of distinct neural structures using single paddle lead to treat multiple pain locations and multi-column, multi-row paddle lead for such neurostimulation

Abstract

In some embodiments, a paddle lead is implanted within a patient such that the electrodes are positioned within the cervical or thoracic spinal levels. An electrode combination on a first row of electrodes can be determined that is effective for a first pain location with minimal effects on other regions of the body. The first pain location can be addressed by stimulating a first dorsal column fiber due to the relatively fine electrical field resolution achievable by the multiple columns. Then, another electrode combination on a second row of electrodes can be determined for a second pain location with minimal effects on other regions. The second pain location could be addressed by stimulating a second dorsal column fiber. After the determination of the appropriate electrodes for stimulation, the patient's IPG can be programmed to deliver pulses using the first and second rows according to the determined electrode combinations.

1 . A stimulation lead for electrically neurostimulating a patient, comprising:
 a rigid paddle structure;   a plurality of electrodes disposed on the paddle structure, wherein the plurality of electrodes are mutually separated by insulative material, wherein the plurality of electrodes comprise not less than five adjacent columns of electrodes disposed laterally along the paddle structure with not less than four rows of electrodes such that the electrodes are spaced at either 1.0 mm or 1.5 mm laterally and at either 2 mm or 3 mm longitudinally;   a lead body of insulative material coupled to the paddle structure at a distal end of the lead body;   a plurality of wire conductors encapsulated within the insulative material of the lead body;   a plurality of terminals on a proximal end of the lead body, wherein the plurality of terminals are electrically coupled to the plurality of electrodes through the plurality of wire conductors.   
     
     
         2 . The stimulation lead of  claim 1  wherein the paddle structure is adapted for implantation in the epidural space within one or several cervical segments of the patient, and wherein the electrodes in the at least five columns are separated longitudinally by 1.5 mm. 
     
     
         3 . The stimulation lead of  claim 1  wherein the paddle structure further comprises an arc along a transverse direction of the paddle structure. 
     
     
         4 . The stimulation lead of  claim 1  wherein the paddle structure further comprises a wing structure on at least one longitudinal side of the paddle structure. 
     
     
         5 . The stimulation lead of  claim 4  further comprising one or more electrodes on the wing structure. 
     
     
         6 . The stimulation lead of  claim 1  wherein the lead is adapted to be implanted in a thoracic vertebral level selected from the group consisting of T 1 , T 2 , T 3 , T 4 , T 5 , T 6 , T 7 , T 8 , T 9 , T 10 , T 11  and T 12 . 
     
     
         7 . The stimulation lead of  claim 1  wherein the lead is configured to span the physiological midline of the patient. 
     
     
         8 . The stimulation lead of  claim 1  wherein the lead is adapted to be implanted in a cervical vertebral level selected from the group consisting of C 1 , C 2 , C 3 , C 4 , C 5 , C 6 , and C 7 . 
     
     
         9 . The stimulation lead of  claim 1  wherein the lead is adapted to be implanted in a lumbar vertebral level selected from the group consisting of L 1 , L 2 , L 3 , L 4 , and L 5 . 
     
     
         10 . A stimulation lead for electrically neurostimulating a patient, comprising:
 a rigid paddle structure;   a plurality of electrodes disposed on the paddle structure, wherein the plurality of electrodes are mutually separated by insulative material, wherein the plurality of electrodes comprise not less than four adjacent columns of electrodes disposed laterally along the paddle structure with not less than four rows of electrodes such that the electrodes are spaced at either 1.0 mm or 1.5 mm laterally and at either 2 mm or 3 mm longitudinally;   a lead body of insulative material coupled to the paddle structure at a distal end of the lead body;   a plurality of wire conductors encapsulated within the insulative material of the lead body;   a plurality of terminals on a proximal end of the lead body, wherein the plurality of terminals are electrically coupled to the plurality of electrodes through the plurality of wire conductors.   
     
     
         11 . A stimulation lead for electrically neurostimulating a patient, comprising:
 a generally planar elongated paddle structure having first face and a second face, a distal end, a proximal end and first and second side edges extending between the distal end and the proximal end;   the distal end being continuously arcuately shaped and extending between the first and second side edges;   the proximal end being continuously arcuately shaped and extending between the first and second edges in a tapered manner;   a plurality of electrodes disposed on the first face of the paddle structure, wherein the plurality of electrodes are mutually separated by insulative material, wherein the plurality of electrodes comprise not less than five adjacent columns of electrodes disposed laterally along the paddle structure with not less than four rows of electrodes such that the electrodes are spaced at either 1.0 mm or 1.5 mm laterally and at either 2 mm or 3 mm longitudinally;   a lead body of insulative material coupled to the arcuate portion of the proximal end of the paddle structure at a distal end of the lead body;   a plurality of wire conductors encapsulated within the insulative material of the lead body; and   a plurality of terminals on a proximal end of the lead body, wherein the plurality of terminals are electrically coupled to the plurality of electrodes through the plurality of wire conductors.