System and methods for diagnosis and treatment of discogenic lower back pain

摘要

Methods and devices to treat discogenic lumbar back pain are disclosed. Electrodes are implanted within the anterior epidural space of the patient. A pulse generator that is connected to the electrodes delivers electrical impulses to sympathetic nerves located within the posterior longitudinal ligament (PLL) of the lumbar spine and outer posterior annulus fibrosus of the intervertebral disc. In alternate embodiments, energy directed to nerves in the PLL may be from light or mechanical vibrations, or the nerves may be cooled. The electrodes may also be used diagnostically to correlate spontaneous nerve activity with spinal movement, fluctuations in autonomic tone and the patient's experience of pain. The electrodes may also be used to generate diagnostic evoked potentials. The diagnostic data are used to devise parameters for the therapeutic nerve stimulation. Automatic analysis of the data may be incorporated into a closed-loop system that performs the nerve stimulation automatically.

主权项

1. A method of treating discogenic lumbar back pain in a patient comprising:
positioning a plurality of electrodes within an anterior epidural space of the patient to a position adjacent to an anatomical structure; wherein said anatomical structure is a posterior longitudinal ligament alone, a posterior annulus fibrosus alone, or said posterior longitudinal ligament and said posterior annulus fibrosus taken together; measuring an activity of one or more nerves in said anatomical structure with said electrodes, wherein said measuring comprises a recording of one or more local field potential; generating energy impulses with a pulse generator; and transmitting said energy impulses to within said anatomical structure or to a device positioned adjacent to said anatomical structure; wherein the nerve activity measurement is used to devise said energy impulses; and wherein the energy impulses are used to at least partially relieve the pain in the patient.