A convenient nerve block puncture-assisted localization and orientation device

Abstract

This invention discloses a convenient nerve block puncture-assisted positioning and orientation device, comprising a positioning device and an orientation device. The positioning device is used to determine the skin entry point for the needle, and the orientation device is used to determine the needle insertion direction. The positioning device consists of two parts: a positioning grid and a positioning ruler. The orientation device consists of a base, two angle rulers, and a guide. The base is used to fix the angle rulers, which can rotate along an axis on the base. After determining the three-dimensional angle, the guide is placed close to the angle rulers to guide the needle-like device for puncture in a fixed direction. This invention can effectively reduce the number of fluoroscopy sessions used by the doctor during positioning; in most cases, the needle entry point can be located with a single fluoroscopy session. This reduces the radiation risk for the patient. It is applicable to common nerve block surgical procedures and is convenient for clinical use.

Description

Technical Field

[0001] This invention relates to the field of medical auxiliary devices for lumbar nerve block, specifically a convenient nerve block puncture-assisted positioning and orientation device and its usage method. Background Technology

[0002] Lower back and leg pain caused by lumbar spine disorders severely impacts patients' health and quality of life. Transforaminal nerve block surgery involves percutaneous injection of anesthetic into specific lumbar nerves to block nerve impulses and achieve pain relief. The key to nerve block surgery lies in accurately placing the needle into the intervertebral foramen region. However, the lumbar spine has a complex structure and is richly surrounded by nerve tissue, posing certain risks during needle placement. Therefore, X-ray fluoroscopy is often used for guidance in clinical practice. However, due to the lack of localization and orientation equipment in actual operation, doctors can only estimate the location and angle of the needle insertion point based on experience, easily leading to inaccurate puncture. Furthermore, repeated fluoroscopy is required during the procedure to confirm the needle insertion location, increasing the patient's radiation risk. To address this issue, some clinicians have introduced surgical navigation systems for precise localization and orientation; however, this approach is costly and increases the complexity of the procedure, making it difficult to widely adopt. Existing positioning and orientation assistive devices for minimally invasive spinal surgery, such as the solution shown in patent CN 105125285A, use linear or arc-shaped slide rails in conjunction with corresponding rockers to provide positioning and orientation functions. However, such assistive devices are often large in size, which increases the complexity of the surgery and limits their clinical application. Summary of the Invention

[0003] The purpose of this invention is to provide a positioning and orientation device for lumbar nerve block, which can achieve the function of positioning and orientation with the reduction of fluoroscopy times; at the same time, it reduces the size of the device, improves its ease of use, and makes it well compatible with the clinical surgical procedure.

[0004] To achieve the above objectives, the present invention adopts the following technical solution: a convenient nerve block puncture-assisted positioning and orientation device, including a positioning device and an orientation device.

[0005] The positioning device consists of two parts: a positioning grid and a positioning ruler. The positioning grid is constructed from a high-density rectangular plastic frame and metal wires. The metal wires are distributed both horizontally and vertically, and are fixed to the plastic frame on both sides by fastening bolts, forming a uniform square metal grid. The metal wires are characterized by a diameter of less than 1 mm, making them detectable by X-rays. The inner edge of the plastic frame is marked with triangles, quadrilaterals, and semicircles to mark the positions of the metal wires.

[0006] The positioning ruler is a rectangular plastic component, comprising an upper plate and a lower plate, connected by a pull-out slot. The upper plate includes a hollowed-out rectangular window, a transparent scale plate, a sliding plate, and an indicator needle. The left side of the upper plate is printed with graduations, and the right side is the hollowed-out rectangular window. The transparent scale plate is fixed to the hollowed-out rectangular window with clips. The transparent scale plate is characterized by two mutually perpendicular graduation lines, with the horizontal graduation line running along the edge of the hollowed-out rectangle. The distance from the starting point of the vertical graduation line to the horizontal graduation line is the same as the side length of the square metal mesh. A straight track is distributed along the outer edge of each of the four sides of the rectangular window. The two sliding plates are perpendicular to each other and connected to the straight tracks via sliding knobs, allowing them to move along the tracks. One end of the indicator needle is fixed to the starting point of the horizontal graduation line on the scale plate and can rotate around that point. The indicator needle is made of metal.

[0007] The orientation device consists of a base, two angle gauges, and a guide. The base secures the angle gauges, which can rotate along an axis on the base. After determining the solid angle, the guide is positioned close to the angle gauge to guide the needle-like device for puncture in a fixed direction. The base is L-shaped and made of metal. Each side of the L-shape has a cuboid, and each cuboid has a cylindrical cavity at its center for connecting the angle gauges. The angle gauges are semi-circular in shape and connected to the cuboids on the base via a cylindrical connecting handle. The diameter of the connecting handle is the same as the diameter of the cylindrical cavity. The angle gauges come in two sizes, with the inner diameter of the larger angle gauge slightly larger than the outer diameter of the smaller angle gauge (the difference being 1mm-2mm). The rotation axes of the two angle gauges intersect, and the centers of the angle gauges are located at the intersection of the selection axes. The outermost part of the connecting handle is threaded and fitted with a nut. The connecting handle near the thread is cut into a square shape, with a matching washer on the square portion. The washer has a circular outer edge and a square internal cutout, consistent with the square shape on the connecting handle. The washer and nut combination is mainly used to fix the angle gauge and prevent it from rotating. The guide has two main features: 1. It has two mutually perpendicular planes; 2. The direction of the guide groove is parallel to the two planes.

[0008] Compared with the prior art, the present invention has the following beneficial effects:

[0009] Using this invention for positioning effectively reduces the number of fluoroscopy sessions required by the doctor during the positioning process; in most cases, a single fluoroscopy session is sufficient to locate the needle insertion point. This reduces the patient's radiation risk. The positioning ruler described in this invention utilizes the characteristic of proportionality between the actual size and the image size, allowing direct measurement of the true physical dimensions from the dimensions in the image, facilitating position determination by the doctor. The invention is small in size, easy to move and carry, suitable for common nerve block procedures, and convenient for clinical use. Attached Figure Description

[0010] Figure 1 This is a top view of the positioning network;

[0011] Figure 2 These are top and side cross-sectional views of the positioning ruler;

[0012] Figure 3 Schematic diagram of the orientation device

[0013] Figure 4 This is a top view of the orientation device;

[0014] Figure 5 This is a cross-sectional view of the guide.

[0015] Figure 6 This is a diagram illustrating the use of the positioning ruler. Detailed Implementation

[0016] The present invention will now be described in further detail with reference to the accompanying drawings and embodiments:

[0017] like Figure 1 As shown, the positioning net in this embodiment includes: a high-density plastic frame 1 and metal wires 2. The high-density plastic frame has an inner frame size of 9cm*18cm and a thickness of 3mm, and an outer frame size of 12cm*21cm. The metal wires are evenly distributed horizontally and vertically, forming a 3cm*3cm metal grid. In this embodiment, the metal wires are steel wires and are connected to the frame 1 by fastening bolts 3. The inner edge of the plastic frame is marked with triangular, quadrilateral, and semi-circular shapes to mark the positions of the metal wires.

[0018] like Figure 2 The diagram shows a positioning ruler in this embodiment: it consists of an upper plate 4 and a lower plate 5, both made of plastic. The upper plate 4 has a slot on its edge, allowing the lower plate 5 to connect and be fixed to the upper plate via the slot. The positioning ruler measures 20cm x 8cm. Both the upper plate 4 and the lower plate 5 have rectangular cutout areas on one side. The upper plate 4 has markings printed on its left side. The rectangular cutout area on the right side measures 8cm x 6cm. A transparent scale plate 6 covers the rectangular cutout area and is fixed by clips on the inside of the upper plate. The transparent scale plate has two perpendicular scale lines printed on it, with the horizontal scale line running along the edge of the cutout rectangle. The distance from the vertical scale line to the starting point 7 of the horizontal scale line is 3cm. A slender indicator needle 8, made of metal, is installed around the starting point 7 of the horizontal scale line and can rotate around the center. The transparent scale plate 6 has two sliding plates 9; each sliding plate 9 has a knob at both ends, which can move along the slide rail 10 in the upper plate 4. All sliding plates are made of plastic. Figure 3The diagram shown is a three-dimensional schematic of the orientation device in this embodiment: it consists of a base 11, an angle ruler 12, and a guide 13. Both the base 11 and the angle ruler 12 are made of metal. The base 11 is L-shaped, and has two cuboids for placing the angle ruler. The cuboids are 10mm x 10mm x 20mm in size, and each cuboid has a 3mm radius hole perforated along its central axis.

[0019] The angle ruler 12 is semi-circular in shape and comes in two sizes: the large angle ruler has an outer diameter of 40mm and an inner diameter of 30mm; the small angle ruler has an outer diameter of 29mm and an inner diameter of 24mm. Both angle rulers have a cylindrical connecting handle 13 with a radius of 3mm. The connecting handle 14 can pass through the cylindrical hole of the cuboid on the base. Figure 4 This is a top view of the orientation device. In actual configuration, it's necessary to ensure that the rotation axes of the large and small angle gauges intersect, and that the centers of the angle gauges are located at the intersection of these axes. Therefore, a positioning protrusion 15 needs to be welded onto the connecting handle to ensure that the centers of the angle gauges remain aligned during rotation. The outermost part of the connecting handle 14 is threaded, and a nut 16 is attached to it. The connecting handle near the threaded portion is cut into a square shape, with a matching washer 17 on the square part. The washer 17 is circular with a square internal cutout, consistent with the square cutout on the connecting handle 14, and its thickness is 3mm. The washer and nut work together to secure the angle gauges, preventing rotation when the nut is tightened.

[0020] The guide 13 is cut from a 1cm*1cm*3cm cuboid, such as... Figure 5 As shown, the shaded area represents the cutting section, where the radius of the central groove is similar to that of the surgical needle. The central groove can be extended by attaching a metal plate for easier positioning.

[0021] To further facilitate those skilled in the art to understand the application advantages and convenience of the present invention, the following are examples of its application in nerve block localization and orientation.

[0022] The above positioning ruler can measure actual physical dimensions in digital images, mainly based on the principle that corresponding sides of similar triangles are proportional. After X-ray fluoroscopy, the human body structure is displayed in a digital image at a certain scale, therefore the dimensions in the digital image differ from the actual physical dimensions. For example... Figure 6 As shown in the schematic diagram, the positioning ruler designed in this invention first constructs a right-angled triangle (referred to as triangle A) during measurement. The legs of this triangle represent the dimensions of the grid lines on the digital image and their actual size of 3cm. For a target dimension to be measured on the digital image, it can be translated into triangle A, intersecting with the hypotenuse. Based on the properties of similar triangles:

[0023] Digital image grid size / measured 3cm = target size to be measured / actual measured size

[0024] Since the measured 3cm corresponds to the actual physical size, the actual measured size in the above formula is the actual physical size corresponding to the target size to be measured.

[0025] In actual measurement, such as Figure 6 As shown, the positioning grid is placed in the patient's back spine region; then X-ray fluoroscopy is performed to obtain the following results. Figure 6 The X-ray perspective view shown on the right. Because the fluoroscopy process involves scaling of the actual object, the resulting digital image differs in scale from the actual physical space, making it impossible to directly measure the actual position of the target point on the digital image. This invention solves this problem. Suppose we want to measure the distance from the pentagram to the target grid line in real physical space. First, align the starting point 7 of the horizontal scale line of the positioning ruler with one intersection point of the target grid line in the digital image, ensuring the horizontal scale is parallel to the target grid line. Then, rotate the indicator needle 8 to the intersection of the vertical scale line and the grid line. Move the horizontal sliding plate past the pentagram, and then move the vertical sliding plate past the intersection of the horizontal sliding plate and the indicator needle. The distance from the starting point to the vertical sliding plate is the actual distance from the pentagram to the target grid line. Thus, the operator can measure the actual positions of multiple target points using the positioning ruler with only one fluoroscopy. Therefore, the operator can easily mark the needle insertion point by measuring the lateral distance and the distance to a specific plane of the vertebra.

[0026] After marking the needle insertion point, the operator can rotate the angle gauge and read the scale according to the planned angle to determine the angle with the horizontal plane and the sagittal plane. In this example, it is assumed that the large angle gauge measures the angle with the horizontal plane, and the small angle gauge measures the angle with the sagittal plane. After determining the angle, tighten the nut 16 of the positioning device to fix the angle gauge; then, the guide is positioned according to... Figure 3 Place the guide on the angle ruler as shown, aligning the tip of the guide with the needle insertion point. Adjust the base orientation appropriately so that one side of the base where the large angle ruler is located is parallel to the axis of the human body. After adjustment, place the base horizontally on the back of the human body to complete the orientation.

Claims

1. A convenient nerve block puncture-assisted positioning and orientation device, characterized in that: The device includes a positioning device and a directional device. The positioning device is used to determine the skin insertion point, and the directional device is used to determine the insertion direction. The positioning device consists of two parts: a positioning grid and a positioning ruler. The directional device consists of a base, two angle rulers, and a guide. The base is used to fix the angle rulers, which can rotate along an axis on the base. After determining the three-dimensional angle, the guide is close to the angle ruler to guide the needle-like device to puncture in a fixed direction. The positioning grid in the positioning device is composed of a high-density rectangular plastic frame and metal wires. The metal wires are evenly distributed in the horizontal and vertical directions and are fixed to the plastic frame on both sides by fastening bolts to form a uniform square metal grid. The positioning ruler is a rectangular plastic component, including an upper layer... The upper and lower plates are connected by a pull-out slot. The upper plate includes a hollow rectangular window, a transparent scale plate, a sliding plate, and an indicator needle. The left side of the upper plate is printed with scales, and the right side is a hollow rectangular window. The transparent scale plate is fixed to the hollow rectangular window with a buckle. The transparent scale plate has two mutually perpendicular scale lines printed on it. The horizontal scale line runs along the edge of the hollow rectangle, and the distance from the starting point of the vertical scale line to the horizontal scale line is the same as the side length of the metal mesh. There is a straight track distributed on each of the four outer edges of the rectangular window. The two sliding plates are perpendicular to each other and are connected to the straight tracks by a sliding button, so they can move along the straight tracks. One end of the indicator needle is fixed at the starting point of the horizontal scale line on the transparent scale plate and can rotate around the starting point. The indicator needle is made of metal. The convenient nerve block puncture-assisted localization and orientation device can achieve the following steps: First, place the positioning grid on the patient's back spine area; then perform X-ray fluoroscopy to obtain an X-ray fluoroscopic image. Align the starting point (7) of the horizontal scale line of the positioning ruler with one of the intersections of the target grid line in the X-ray fluoroscopic image, and make the horizontal scale line parallel to the target grid line. Then, rotate the pointer (8) to the intersection of the vertical scale line and the grid line, move the horizontal sliding plate to pass the target point, and then move the vertical sliding plate to pass the intersection of the horizontal sliding plate and the pointer. At this time, the distance from the starting point to the vertical sliding plate is the actual distance from the target point to the target grid line. The operator can use the positioning ruler to measure the actual position of multiple target points with only one fluoroscopy.

2. The convenient nerve block puncture-assisted positioning and orientation device according to claim 1, characterized in that: The metal wire is characterized by a diameter of less than 1 mm and can be detected by X-rays.

3. The convenient nerve block puncture-assisted positioning and orientation device according to claim 1, characterized in that: The inner edge of the plastic frame is marked with triangles, quadrilaterals, and semicircles to mark the position of the metal wires.

4. The convenient nerve block puncture-assisted positioning and orientation device according to claim 1, characterized in that: The base of the orientation device is an L-shaped metal structure. There is a cuboid on each side of the L-shape, and a cylindrical hole in the center of each cuboid for connecting an angle ruler.

5. The convenient nerve block puncture-assisted positioning and orientation device according to claim 4, characterized in that: The main body of the angle ruler is semi-circular, and it is connected to a cuboid on the base through a cylindrical connecting handle. The diameter of the connecting handle is the same as the diameter of the cylindrical cavity. The angle ruler comes in two sizes, with the inner diameter of the larger angle ruler being slightly larger than the outer diameter of the smaller angle ruler, with a difference of 1mm-2mm. The rotation axes of the two angle rulers intersect, and the centers of the angle rulers are both located at the intersection of the rotation axes.

6. The convenient nerve block puncture-assisted positioning and orientation device according to claim 5, characterized in that: The outermost part of the connecting handle is threaded and connected to a nut. The connecting handle near the threaded part is cut into a square shape, and there is a matching washer on the square part. The outer edge of the washer is round, and the inside is hollowed out into a square shape, which is consistent with the square shape on the connecting handle. The washer and the nut are combined to fix the angle gauge and prevent it from rotating. The guide has two mutually perpendicular planes, and the direction of the guide groove is parallel to the two planes.

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