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.

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.

The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a cross-sectional view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.

A wireless charger system for inductively charging a rechargeable battery of an implantable pulse generator (IPG) implanted in a human body is provided. A charging coil in the charger is wirelessly coupled to a receiving coil of the IPG to charge the rechargeable battery. An end-of-charge (EOC) circuit continuously monitors the reflected impedance from a reflected impedance sensor and determines the end of charge when a predetermined pattern of the reflected impedance corresponding to an EOC signal from the IPG is received. Advantageously, receiving the EOC signal through the charging coil eliminates the need to provide a separate communication circuit in the IPG that communicates with the charger.

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.

Devices, systems, and techniques are described to detect when a power transmitting and receiving system is in an inefficient position, which may cause a thermal response that less desirable than a more efficient position. The system may power transmitting device configured to wirelessly transfer electromagnetic energy to a power receiving device. Processing circuitry of the system may compute a target output power deliverable by the power transmitting device for a first duration and control the power transmitting device to output the target output power based in part on a heat limit. The processing circuitry may further calculate an energy transfer efficiency to the power receiving unit, update an adjustment factor based on the calculated energy transfer efficiency, and apply the adjustment factor to the heat limit for a subsequent duration.

An Implantable Pulse Generator (IPG) is disclosed that is capable of sensing a degree to which recruited neurons in a patient's tissue are firing synchronously, and of modifying a stimulation program to promote desynchronicity and to reduce paresthesia. An evoked compound action potential (ECAP) of the recruited neurons is sensed as a measure of synchronicity by at least one non-active electrode. An ECAP algorithm operable in the IPG assesses the shape of the ECAP and determines one or more ECAP shape parameters that indicate whether the recruited neurons are firing synchronously or desynchronously. If the shape parameters indicate significant synchronicity, the ECAP algorithm can adjust the stimulation program to promote desynchronous firing.

Devices and methods to effectuate closed loop electrical stimulation of nerve tissue, based on feedback data, to mitigate pain of a patient are disclosed. Feedback data corresponding to bioelectric signals of neurons stimulated by stimulation pulses may be received and analyzed. Based on receipt of the feedback data, it may be determined to modify one or more stimulation parameters, corresponding to the stimulation pulses, to enhance an efficacy of the stimulation pulses at blocking generation and/or propagation of one or more pain signals through a neuroanatomy of the patient. Subsequent and additional stimulation pulses may be provided based on a modified set of stimulation parameters and configured to enhance attenuation of generation and/or transmission of pain signals through the neuroanatomy of the patient to ultimately reduce a level of pain experienced by the patient.

Devices and methods for manipulating devices such as micro-scale devices are provided. The devices can include a tether of various materials surrounded by a stiff body. The tether interfaces with microscale devices to draw them against the stiff body, holding the microscale devices in a locked position for insertion into or extraction out of tissue. The tensional hook and stiff body are configurable in a multitude of positions and geometries to provide increased engagement. Such configurations allow for a range of implantation and extraction surgical procedures for the device within research and clinical settings.