A system for neuromodulation, at least including a timeline definition module configured to define a timeline in which neuromodulation may be provided; A timeline dividing module for dividing the timeline into a series of time slots; several neuromodulation entities, each entity being capable to claim at least one slot exclusively for providing neuromodulation.

This document discusses, among other things, systems and methods for managing pain in a subject. A system may include one or more sensors configured to sense from the subject information corresponding to emotional reaction to pain, such as emotional expression. The emotional expression includes facial or vocal expression. A pain analyzer circuit may generate a pain score using signal metrics of facial or vocal expression extracted from the sensed information. The pain score may be output to a user or a process. The system may additionally include a neurostimulator that can adaptively control the delivery of pain therapy by automatically adjusting stimulation parameters based on the pain score.

An example method includes delivering, by an implantable medical device and during a first period of time, high density electrical neurostimulation therapy to a patient using a first set of electrodes of a plurality of electrodes; and delivering, by the implantable medical device and during a second period of time, high density electrical neurostimulation therapy to the patient using a second set of electrodes of the plurality of electrodes.

A system and method for extracting a cardiac signal from a spinal signal include measuring a spinal signal at one or more electrodes that are connected to a neurostimulator and implanted within a patient's spinal canal and processing the spinal signal to extract the cardiac signal, which includes features that are representative of the patient's cardiac activity. Processing the spinal signal to extract the cardiac signal can include filtering the spinal signal, or use of model reduction schemes such as independent component analysis. The extracted cardiac signal can include a number of features that correspond to an electrocardiogram and can be used to determine the patient's heart rate and/or to detect a cardiac anomaly. Cardiac features that are determined from the cardiac signal can additionally be used to adjust parameters of the stimulation that is provided by the neurostimulator.

Embodiments relate to a crosslinked citrate-based elastomer catheter that is biodegradable and kink resistant. Embodiments of the crosslinked citrate-based elastomer material swells when surrounded by fluid (body fluid) so as to anchor the catheter to tissue but not anchor it so much that movement or removal will cause tissue damage. The catheter can be used as a component to a peripheral nerve block device, for example. Embodiments of the catheter can include embedding biodegradable sensors, moieties, shape memory material, etc. to monitor and modulate functions of the catheter and/or peripheral nerve block.

The present disclosure provides a stimulation lead for providing stimulation signals to nerve tissue and improved methods for constructing and manufacturing such a stimulation lead. The stimulation lead and/or methods includes a lead with a cable disposed within. At each end of the lead body a portion of the cable is exposed, and a metal ferrule is securely attached to the exposed cable portion. An electrode/contact is then securely attached to the metal ferrule such that the electrode covers the metal ferrule, a portion of the lead body, and a transition point where the exposed cable exits the lead body. A tine component may be swaged around a portion of the term end, configured to provide a retaining force against an force acting upon the stimulation lead, while allowing insertion of the stim end of the stimulation lead during implantation, and extraction of the stim end during explantation.

Provided herein are methods of treating a patient comprising providing a medical apparatus comprising an external system and an implantable system, implanting the implantable system, and delivering at least one of power or data to the implantable system with the external system. The external system comprises: at least one external antenna configured to transmit a first transmission signal to the implantable system; an external transmitter configured to drive the at least one external antenna; an external power supply; and an external controller. The implantable system comprises: at least one implantable antenna configured to receive the first transmission signal from the first external device; an implantable receiver; at least one implantable functional element configured to interface with the patient; an implantable controller; an implantable energy storage assembly; and an implantable housing surrounding at least the implantable controller and the implantable receiver. Medical apparatus are also provided.

The present invention provides a single surgical method, procedure and/or system that creates open visual and physical access to an identified spinal treatment site that comprises both targeted vertebral and spinal levels to be treated, wherein the spinal levels comprise at least one dorsal root ganglion. A spinal treatment procedure is performed generally in combination with implantation of a neuromodulation system that may comprise placement of electrical lead(s) on the at least one dorsal root ganglion, wherein each lead is in operative connection with a pulse generator that may also be implanted during the surgical method. Electrical stimulation may be generated with the pulse generator through the electrical leads to the at least one dorsal root ganglion during and/or after the closure of the identified spinal treatment site.

A system for restoring muscle function to the lumbar spine to treat low back pain is provided. The system may include electrodes coupled to an implantable pulse generator (IPG), a handheld activator configured to transfer a stimulation command to the IPG, and an external programmer configured to transfer programming data to the IPG. The stimulation command directs the programmable controller to stimulate the tissue in accordance with the programming data. The system may include a software-based programming system run on a computer such that the treating physician may program and adjust stimulation parameters.

Apparatus and methods for treating back pain are provided, in which an implantable stimulator is configured to communicate with an external control system, the implantable stimulator providing a neuromuscular electrical stimulation therapy designed to cause muscle contraction to rehabilitate the muscle, restore neural drive and restore spinal stability; the implantable stimulator further including one or more of a number of additional therapeutic modalities, including a module that provides analgesic stimulation; a module that monitors muscle performance and adjusts the muscle stimulation regime; and/or a module that provides longer term pain relief by selectively and repeatedly ablating nerve fibers. In an alternative embodiment, a standalone implantable RF ablation system is described.