Methods and systems for providing electrical stimulation to a patient's spinal cord using electrode leads implanted in the patient's spinal column are described. Embodiments involve cycling between durations during which stimulation is actively applied and durations when no stimulation is applied. The stimulation can be configured such that pain relief washes in during the active stimulation duration and continues for some part of the duration when no stimulation is being applied. Eventually the pain relief may wash out. The washout time may be modeled, so that stimulation may be resumed before the pain relief washes out. The stimulation may be below the patient's perception threshold.

A system and method for treating pain without paresthesia by spinal cord stimulation.

A severed nerve may be surgically rejoined and severed axons fused via sequential administrations of solutions. The solutions may include a priming solution comprising methylene blue in a Ca.sup.2+-free saline solution, a fusion solution comprising about 50% (w/w) PEG, and a sealing solution comprising Ca.sup.2+-containing saline. The PEG fusion solution may be applied in a nerve treatment device configured to isolate the injured segment of the nerve. The device may include a containment chamber for creating a fluid containment field around the anastomosis. The device may have slits, slots, and/or apertures in opposing endwalls of the device designed to receive the nerve. The device may have an open bath configuration or may include separable lower and upper bodies to create a closed bath configuration. The device may include one or more fluid ports in fluid communication with the containment chamber for introducing and/or removing fluid.

In one embodiment, a method of implanting a stimulation lead to stimulate a dorsal root ganglion (DRG) of a patient, comprises: placing a distal portion of the stimulation lead within an implant tool; accessing the epidural space of the patient with the distal end of the implant tool; contacting a surface of a pedicle of the patient with a distal tip of the implant tool above a foramen leading to a target DRG; after contacting the surface of the pedicle with the distal tip, advancing the stimulation lead from a side port of the implant tool, wherein the side port is located proximal to the distal tip of the implant tool; advancing the stimulation lead through the foramen to position one or more electrodes of the stimulation lead adjacent to the target DRG; and providing electrical stimulation to the target DRG to stimulate the target DRG using one or more electrodes of the stimulation lead.

An adapter system connects to implantable electrode leads. The adapter system has the pulse generator configured to generate electrical stimulation pulses and has a first connector member. The adapter has a housing containing two receptacles. Each receptacle receives an end portion of an electrode lead to establish an electrical connection between the adapter and the electrode lead. The adapter contains a second connector member configured to engage with the first connector member to establish a mechanical connection between the housing and the pulse generator and an electrical connection between the pulse generator and the electrode lead. A test cable electrically connects the pulse generator to the electrode leads for testing the electrode leads. The test cable contains a first connector member configured to engage with the second connector member to establish an electrical connection. The test cable contains a second connector member configured to engage with the first connector member.

A lead body is operable to be implanted proximate a target nerve tissue of a patient. A sensing electrode is configured to sense biopotentials over a first partial circumference of the lead body. A stimulation electrode is configured to deliver stimulation energy over a second partial circumference of the lead body. A signal generator is electrically coupled to the stimulation electrode and a sensing circuit is coupled to the sensing electrode. A processor is operable to apply a stimulation signal to the stimulation electrode via the signal generator and, via the sensing circuit, sense an evoked response to the stimulation signal that propagates along a neural pathway.

One aspect is a process for producing a segmented electrode, including providing a pipe made of metal having an outer side and an inner side, wherein the inner side of the pipe forms a hollow space. A support structure is arranged in the hollow space, so that the support structure mechanically stabilizes the pipe. Intermediate spaces are formed in the pipe, which define a plurality of segments in the pipe. An electrically insulating material is introduced into the intermediate spaces and thus forming electrically insulating areas, wherein a boundary layer is in each case defined between the segments and the areas. The pipe is cut so that several segmented ring-shaped electrodes are formed therefrom. The support structure is removed from the pipe.

Methods and systems are disclosed for modulating glycaemia in a patient in which an activating stimulation signal is applied at an activating location at the vagus nerve, the activating stimulation signal configured to evoke a neural response in the vagus nerve; and a blocking stimulation signal is applied at a blocking location at the vagus nerve, the blocking stimulation signal configured to inhibit transmission of the evoked neural response along the vagus nerve past the blocking location; to produce unidirectional vagal nerve stimulation, the unidirectional vagal nerve stimulation being effective to modulate glycaemia in the patient.

The present invention provides a robotic navigation system for identifying a target nerve for guiding and/or performing the implanting a neuromodulation device at the target nerve wherein the neuromodulation device includes a pulse generator and at least one lead in electrical or operative connection with the pulse generator. In some embodiments, the location of the robotically advanced lead and electrode may be imaged and displayed on a display and/or may be visually annunciated using one or more lights to indicate whether the placement location of the lead or electrode is within or outside of a predetermined distance of the target nerve.

A system can utilize interleaving periods or waveforms to stimulate patient tissue and sense signals using the stimulation electrodes. For example, the system can utilize alternating therapeutic periods and sensing periods. As another example, the system can alternate between biphasic waveforms having opposite temporal orders of positive and negative phases. As another example, waveforms that differ in a parameter, such as amplitude or pulse width, can be interleaved to provide different information in the respective sensed signals.