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 a posterior longitudinal ligament and/or a posterior annulus fibrosus; generating one or more electrical impulses with a pulse generator; and transmitting the electrical impulses through said electrodes to one or more nerves in said posterior longitudinal ligament and/or said posterior annulus fibrosus; wherein the electrical impulses are sufficient to cause one or more sympathetic nerves in the posterior longitudinal ligament and/or in the posterior annulus fibrosus to inhibit an initiation and/or a transmission of an action potential in one or more nociceptive nerves in the posterior longitudinal ligament and/or in the posterior annulus fibrosus; and wherein the electrical impulses at least partially relieve the pain without producing irreversible damage in any tissue of the patient.