Lumbar intervertebral disc puncture device and puncture method based on three-dimensional CT

Abstract

The invention relates to a lumbar intervertebral disc puncture device based on three-dimensional CT and a puncture method.The lumbar intervertebral disc puncture device based on the three-dimensional CT comprises a transverse sliding rail, a longitudinal ruler and a puncture cannula, the transverse sliding rail is a long-strip-shaped sliding rail with scales, the longitudinal ruler is a long-strip-shaped ruler with scales, an arrow is arranged at one end of the longitudinal ruler, and the transverse sliding rail is a long-strip-shaped sliding rail with scales. The longitudinal scale is movably installed on the transverse sliding rail through a first connecting piece and can slide left and right on the transverse sliding rail, a second connecting piece at the end of one side of the transverse sliding rail is movably connected with a puncture cannula, and the puncture cannula can swing left and right or rotate front and back at the end of the transverse sliding rail. The designed device is simple and convenient, and the scheme is easy to learn; according to the method, the puncture point and the puncture angle can be conveniently found in the operation according to the pre-operation plan, the operation can be rapidly and accurately completed, low-age doctors can be helped to rapidly master operation skills by applying the method, and the method can be used for operation training.

Description

Technical Field

[0001] This invention belongs to the field of medical device technology and relates to a lumbar intervertebral disc puncture device and puncture method based on three-dimensional CT. Background Technology

[0002] Low pack pain (LBP) is one of the most common causes of lumbar spine dysfunction, affecting more than 80% of the world's population. Low pack pain caused by intervertebral disc degeneration is called discogenic low pack pain, and radiofrequency ablation (RFA) is an important treatment for it. During lumbar disc radiofrequency ablation surgery, it is crucial to insert a puncture needle into the affected intervertebral disc segment. However, performing this puncture with the aid of X-ray fluoroscopy can be challenging, especially for inexperienced young physicians. Multiple punctures and fluoroscopy sessions are often required to reach the target point, increasing surgical time, the number of fluoroscopy sessions, and patient discomfort. Pre-operative planning and parameter measurement of lumbar radiofrequency ablation can clearly define the puncture point, direction, and depth, and the use of convenient puncture aids can reduce puncture deviations, ultimately shortening surgical time, reducing the number of fluoroscopy sessions, and alleviating patient discomfort.

[0003] Traditional lumbar puncture methods rely on experience to perform punctures at different surgical segments, or involve roughly drawing the puncture point and angle on the patient's body after preoperative measurements using CT scans. These methods are often inaccurate, requiring multiple adjustments during the procedure based on fluoroscopy, and can sometimes result in significant errors. Therefore, the learning curve for this percutaneous lumbar puncture technique is quite steep, posing a considerable challenge for young physicians.

[0004] Currently, domestic scholars have designed various puncture auxiliary devices for lumbar puncture techniques. The problems are that the devices are large and complicated to use. Some of them only guide the implementation of three-dimensional surgery through the measurement of two-dimensional images, which results in poor positioning accuracy.

[0005] To address this issue, a lumbar disc puncture device and puncture method based on three-dimensional CT were designed to overcome the aforementioned problems. Summary of the Invention

[0006] The purpose of this invention is to overcome the shortcomings of existing technologies and provide a simple and reasonable lumbar disc puncture device and method based on three-dimensional CT. This invention first performs precise simulation and measurement on three-dimensional images, and then uses the invented device for planning and implementation. This allows for rapid and accurate location of the puncture point, as well as precise determination of the puncture angle and depth, thereby reducing surgical time, fluoroscopy sessions, and patient discomfort, ultimately improving surgical efficiency and achieving more satisfactory surgical results.

[0007] The present invention is achieved through the following technical solution: a lumbar disc puncture device based on three-dimensional CT, comprising a transverse slide rail, a longitudinal scale, and a puncture cannula. The transverse slide rail is a long strip slide rail with graduations, and the longitudinal scale is a long strip scale with graduations. An arrow is provided at one end of the longitudinal scale. The longitudinal scale is movably mounted on the transverse slide rail through a first connector and can slide left and right on the transverse slide rail. A second connector is movably connected to the puncture cannula at one end of the transverse slide rail. The puncture cannula can swing left and right or rotate back and forth at the end of the transverse slide rail.

[0008] Preferably, the first connecting member is a slider, which is hollow inside and can be fitted onto a longitudinal scale to slide left and right. A transverse slide rail is installed on the slider, and bolt holes are correspondingly opened on the slider and the transverse slide rail. After the position of the transverse slide rail is adjusted, the position is locked by installing bolts in the bolt holes.

[0009] Preferably, the second connector is a turntable. One end of the turntable is movably connected to the end of the transverse slide rail via a first rotating shaft. A U-shaped clamping part is fixedly installed in the middle of the side of the turntable away from the transverse slide rail. A puncture tube is movably installed in the middle of the clamping part via a second rotating shaft. A sector-shaped angle ruler with the same center as the turntable is installed on the outer circumference of the turntable. An angle scale is provided on the sector-shaped angle ruler. A pointer is provided at the middle of the sector-shaped angle ruler at the top of the turntable. The pointer is attached to the side of the sector-shaped angle ruler and corresponds to the position of the puncture tube. When the turntable rotates, it drives the pointer and the puncture tube on the clamping part to rotate back and forth together. The rotation angle of the puncture tube is displayed by the pointer.

[0010] Preferably, a semi-circular or quarter-circular angle ruler is installed on the upper part of one side of the clamping part. An angle ruler (14) is provided with an angle scale. The angle ruler is parallel to and adjacent to the puncture tube and is used to display the left and right swing angle of the puncture tube through the angle scale on the angle ruler.

[0011] Preferably, the transverse slide rail, longitudinal scale, and puncture cannula are all made of titanium alloy composite material that can be visualized under X-ray fluoroscopy, for ease of operation.

[0012] A lumbar disc puncture method based on three-dimensional CT includes the following steps: (1) Preoperative planning steps: S1 acquires the patient's lumbar spine CT images and exports them as DICOM format files; S2 uses medical imaging software for 3D reconstruction; S3 simulates the puncture path in a 3D model and measures key parameters: the distance s from the puncture point to the midline of the spine, the transverse angle α, the sagittal angle β, and the puncture depth z. (2) Intraoperative procedures: With the patient in a prone position, align the longitudinal scale of the device with the midline of the spine, with the arrow pointing towards the patient's head and parallel to the ground. The transverse slide rail should project past the puncture point. S5 adjusts the lateral slide rail so that the lateral distance equals the preoperatively planned S value; S6 rotates and swings the puncture cannula to the transverse angle α, and rotates the turntable 5 to the sagittal angle β. S7 inserts the puncture needle along the puncture cannula to depth z, completing the precise puncture.

[0013] Preferably, the medical imaging software in step S2 is MIMICS 19.0.

[0014] Preferably, in step S3, the cross-sectional angle α is the angle between the puncture needle in the cross-section and the midline of the spine, the sagittal angle β is the angle between the puncture needle in the sagittal plane and the perpendicular line to the coordinate axis, and the puncture depth z is the length of the puncture needle in the three-dimensional model.

[0015] The beneficial effects of this invention are as follows: 1) This invention establishes a three-dimensional coordinate system through the scaled design of the transverse slide rail and the dual-degree-of-freedom adjustment of the longitudinal scale (sliding / rotation). Combined with the swing function of the puncture cannula, it can accurately reproduce the pre-planned lateral distance s, transverse angle α, and sagittal angle β. Compared with traditional manual puncture, it can significantly reduce the error range. This device can greatly improve puncture accuracy, ensuring that the puncture needle tip accurately reaches the intervertebral disc target point and avoids damage to nerve roots or blood vessels.

[0016] 2) The method of this invention uses MIMICS software to perform three-dimensional reconstruction of DICOM images before surgery, which can virtually simulate the puncture path and calculate the optimal parameter combination. Intraoperative procedures only require three steps of adjustment: aligning the longitudinal ruler with the spinal midline and ensuring the transverse slide rail projects past the puncture point; adjusting the transverse slide rail to the S-value scale; and rotating the cannula to the α and β angles. This process significantly saves puncture positioning time, reduces the risk of respiratory depression caused by prolonged prone positioning, and lowers the incidence of iatrogenic injury.

[0017] 3) The device of this invention uses an X-ray-visible titanium alloy composite material, enabling the device to present high-contrast images under CT / X-ray fluoroscopy. Combined with the continuous scale markings on the slide rail, it achieves a three-dimensional real-time correspondence between the device, image, and anatomy. The device position can be verified during surgery using a single fluoroscopy, reducing radiation exposure compared to traditional multiple fluoroscopy positioning methods. If performing lumbar disc puncture from the patient's left side, the device arrow can be pointed directly towards the patient's tailbone; the rest of the operation remains the same.

[0018] 4) This invention replaces experience-based judgment with quantitative parameters (s / α / β / z), transforming the puncture procedure into a repeatable, standardized process. Junior physicians can master parameter adjustment techniques with short-term training, avoiding puncture failures due to experience differences. The linear distance measurement function for the puncture depth z, combined with depth markings at the cannula end, ensures real-time controllability of the needle advancement process, preventing over-puncture and complications such as intervertebral discitis.

[0019] 5) The high-precision puncture device of this invention enables precise drug injection during discography, improving the effectiveness of pain management. In interventional treatments such as discoplasty and radiofrequency ablation, a precise puncture path can improve the accuracy of energy deposition and reduce thermal damage to surrounding healthy tissues. Postoperative CT scans show that the disc puncture path in patients using this device closely matches the pre-operative planned path, significantly reducing the rate of secondary punctures and related medical disputes.

[0020] In summary, the device of this invention is simple and easy to learn. The materials of the device can be visualized under X-ray fluoroscopy and can be adjusted according to the fluoroscopic situation. Furthermore, each component can be sterilized to meet surgical standards and can be used during surgery. This invention constructs a closed-loop precision puncture system from preoperative planning to intraoperative execution through precise adjustment of the mechanical structure and quantitative planning of three-dimensional images. It has significant technical advantages and clinical value in improving surgical accuracy, shortening operation time, reducing radiation exposure, and reducing complications. Moreover, the device and method of this invention can help junior physicians quickly master surgical skills and can be used for surgical training. Attached Figure Description

[0021] Figure 1 This is a schematic diagram of the overall three-dimensional structure of the present invention; Figure 2 This is a schematic diagram of the overall structure of the present invention (front view); Figure 3 This is a schematic diagram of the overall structure of the present invention (side view). Figure 1 ); Figure 4 This is a schematic diagram of the overall structure of the present invention (side view). Figure 2 ); Figure 5 These are coronal, transverse, sagittal, and three-dimensional views of the present invention. Figure 6 This is a three-dimensional stereoscopic image illustration of the present invention. Figure 1 ; Figure 7 This is a three-dimensional stereoscopic image illustration of the present invention. Figure 2 ; Figure 8 This is a three-dimensional stereoscopic image illustration of the present invention. Figure 3 . Detailed Implementation

[0022] To enable those skilled in the art to more clearly understand the purpose, technical solution, and advantages of the present invention, the present invention will be further described below in conjunction with the accompanying drawings and embodiments.

[0023] In the description of this invention, it should be understood that the orientation or positional relationship indicated by terms such as "upper", "lower", "left", "right", "inner", "outer", "lateral", and "vertical" is based on the orientation or positional relationship shown in the accompanying drawings and is only for the convenience of describing this invention, and is not intended to indicate or imply that the device or component referred to must have a specific orientation, and therefore should not be construed as a limitation of this invention.

[0024] The invention will now be described in detail with reference to the accompanying drawings: Figure 1-4 As shown, a lumbar disc puncture device based on three-dimensional CT includes a transverse slide rail 1, a longitudinal scale 2, and a puncture cannula 3. The transverse slide rail 1 is a long strip slide rail with graduations, and the longitudinal scale 2 is a long strip scale with graduations. An arrow 15 is provided at one end of the longitudinal scale 2. The longitudinal scale 2 is movably mounted on the transverse slide rail 1 through a first connector 4 and can slide left and right on the transverse slide rail 1. The puncture cannula 3 is movably connected to a second connector 5 at one end of the transverse slide rail 1. The puncture cannula 3 can swing left and right or rotate back and forth at the end of the transverse slide rail 1.

[0025] The first connecting member 4 is a slider. The slider is hollow inside and is used to slide left and right on the longitudinal scale 2. A transverse slide rail 1 is installed on the slider, and bolt holes 7 are opened on the slider and the transverse slide rail 1 respectively. After the position of the transverse slide rail 1 is adjusted, the position is locked by installing bolts 8 in the bolt holes 7.

[0026] The second connecting component 5 is a turntable. One end of the turntable is movably connected to the end of the transverse slide rail 1 via a first rotating shaft 11. A U-shaped clamping part 10 is fixedly installed at the middle position of the side of the turntable away from the transverse slide rail 1. A piercing sleeve 3 is movably installed in the middle of the clamping part 10 via a second rotating shaft 12. A sector-shaped angle ruler 6 with the same center as the turntable is installed on the outer circumference of the turntable. An angle scale 13 is provided on the sector-shaped angle ruler 6, and a pointer 9 is provided at the middle position of the sector-shaped angle ruler 6 at the top of the turntable. The pointer 9 is attached to the side of the sector-shaped angle ruler 6, and the position of the pointer 9 corresponds to that of the piercing sleeve 3. When the turntable rotates, it drives the pointer 9 and the piercing sleeve 3 on the clamping part to rotate back and forth together, and the pointer 9 indicates the rotation angle of the piercing sleeve 3. Bolts can be installed on both the first and second rotating shafts. After rotating to the corresponding angle, the position is locked by the bolts for easy operation.

[0027] A semi-circular or quarter-circular angle ruler 14 is installed on the upper part of one side of the clamping part 10. Angle ruler 14 is provided with angle scale. The angle ruler 14 is parallel to and adjacent to the puncture cannula 3 and is used to display the left and right swing angle of the puncture cannula 3 through the angle scale on the angle ruler 14.

[0028] The transverse slide rail 1, longitudinal scale 2, and puncture cannula 3 are all made of titanium alloy composite material that can be visualized under X-ray fluoroscopy for ease of operation.

[0029] like Figure 5-8 As shown, a lumbar disc puncture method based on three-dimensional CT includes the following steps: 1) Preoperative planning steps: S1) Acquire the patient's lumbar spine CT images and export them as DICOM format files; S2) Use medical imaging software for 3D reconstruction; S3) Simulate the puncture path in the three-dimensional model and measure key parameters: distance s from the puncture point to the midline of the spine, cross-sectional angle α, sagittal angle β, and puncture depth z. 2) Intraoperative procedures: S4) With the patient in a prone position, align the longitudinal scale 2 of the device with the midline of the spine, with the arrow pointing towards the patient's head and parallel to the ground, and project the transverse slide rail past the puncture point. S5) Adjust the transverse slide rail 1 so that the lateral distance is equal to the preoperatively planned s value; S6) Swing the puncture cannula 3 to the transverse angle α, and rotate the turntable 5 to the sagittal angle β; S7) Insert the puncture needle along the puncture cannula 3 to depth z to complete the precise puncture.

[0030] The medical imaging software used in step S2 is MIMICS 19.0.

[0031] In step S3, the cross-sectional angle α is the angle between the puncture needle in the cross-section and the midline of the spine, the sagittal angle β is the angle between the puncture needle in the sagittal plane and the vertical line to the ground, and the puncture depth z is the length of the puncture needle in the three-dimensional model. Example

[0032] Preoperative planning steps: (1) Before the operation, the patient’s lumbar spine was examined by CT, and the CT images were exported in DICOM format and three-dimensional reconstruction was performed in MIMICS 19.0 software; (2) Perform intervertebral disc puncture in the software by simulating the puncture needle according to the conventional puncture method; (3) Below Figure 5For example, we measured various parameters. The distance from the point where the puncture needle contacts the skin to the midline of the spine is s = 108.71 mm, the puncture angle in the transverse plane is α, and the puncture angle in the sagittal plane is β.

[0033] like Figure 6-8 As shown, the demonstration is presented on a 3D image: On the coronal plane, z represents the simulated puncture needle. The midline a of the spine is drawn, and the distance s from the puncture point X to the midline a is 108.71 mm. Figure 6 On the cross-section, the angle α between a and the puncture needle z is 53.34°. Figure 7 On the sagittal plane, draw a perpendicular line b from the puncture point X to the ground, with the angle β between b and z being 44.03°. Figure 8 The puncture is performed at the angle of the reference line z, and the puncture depth is the simulated puncture needle length z = 142.736 mm.

[0034] Intraoperative procedures: (1) The patient lies prone on the operating table. The positioning frame is placed on the patient's waist. The longitudinal scale coincides with the midline of the spine, the arrow points to the patient's head, and the transverse slide rail is projected past the puncture point. (2) Move the puncture cannula away from the longitudinal scale by a distance s; (3) Swing the piercing sleeve 3 at an angle α on the cross section and rotate the turntable 5 at an angle β on the sagittal plane respectively; (4) Insert the puncture needle into the puncture sleeve 3. The point of contact with the skin is the puncture point X, which is the puncture direction. The puncture depth is the simulated puncture needle length z.

[0035] The specific embodiments described herein are merely illustrative of the principles and effects of the invention and are not intended to limit the invention. Any person skilled in the art can modify or alter the above embodiments without departing from the spirit and scope of the invention. Therefore, all equivalent modifications or alterations made by those skilled in the art without departing from the spirit and technical concept disclosed in this invention should still be covered by the claims of this invention.

Claims

1. A lumbar disc puncture device based on three-dimensional CT, comprising a transverse slide rail (1), a longitudinal scale (2), and a puncture cannula (3), characterized in that: The transverse slide rail (1) is a long strip slide rail with graduations, and the longitudinal scale (2) is a long strip scale with graduations. An arrow (15) is provided at one end of the longitudinal scale (2). The longitudinal scale (2) is movably installed on the transverse slide rail (1) through the first connector (4) and can slide left and right on the transverse slide rail (1). The second connector (5) is movably connected to the puncture tube (3) at one end of the transverse slide rail (1). The puncture tube (3) can swing left and right or rotate back and forth at the end of the transverse slide rail (1).

2. The lumbar disc puncture device based on three-dimensional CT according to claim 1, characterized in that: The first connector (4) is a slider. The slider is hollow inside and is used to slide left and right on the longitudinal scale (2). A transverse slide rail (1) is installed on the slider, and bolt holes (7) are opened on the slider and the transverse slide rail (1). After the position of the transverse slide rail (1) is adjusted, the position is locked by installing bolts (8) in the bolt holes (7).

3. The lumbar disc puncture device based on three-dimensional CT according to claim 1, characterized in that: The second connector (5) is a turntable. One end of the turntable is movably connected to the end of the transverse slide rail (1) through the first rotating shaft (11). A U-shaped clamping part (10) is fixedly installed in the middle of the side of the turntable away from the transverse slide rail (1). A puncture tube (3) is movably installed in the middle of the clamping part (10) through the second rotating shaft (12). A fan-shaped angle ruler (6) with the same center as the turntable is installed on the outer periphery of the turntable. An angle scale (13) is set on the fan-shaped angle ruler (6). A pointer (9) is set at the top of the turntable in the middle of the fan-shaped angle ruler (6). The pointer (9) is attached to the side of the fan-shaped angle ruler (6). The pointer (9) and the position of the puncture tube (3) are corresponding front and back. When the turntable rotates, it drives the pointer (9) and the puncture tube (3) on the clamping part to rotate back and forth together. The rotation angle of the puncture tube (3) is displayed by the pointer (9).

4. The lumbar disc puncture device based on three-dimensional CT according to claim 3, characterized in that: A semi-circular or quarter-circular angle ruler (14) is installed on the upper part of one side of the clamping part (10). An angle ruler (14) is provided with an angle scale. The angle ruler (14) is parallel to and adjacent to the puncture cannula (3) and is used to display the left and right swing angle of the puncture cannula (3) through the angle scale on the angle ruler (14).

5. The apparatus according to claim 1, characterized in that: The transverse slide rail (1), longitudinal scale (2), and puncture cannula (3) are all made of titanium alloy composite material that can be visualized under X-ray fluoroscopy, for ease of operation.

6. A method for lumbar disc puncture based on three-dimensional CT, characterized in that, Includes the following steps: (1) Preoperative planning steps: S1 acquires the patient's lumbar spine CT images and exports them as DICOM format files; S2 uses medical imaging software for 3D reconstruction; S3 simulates the puncture path in a 3D model and measures key parameters: the distance s from the puncture point to the midline of the spine, the transverse angle α, the sagittal angle β, and the puncture depth z. (2) Intraoperative procedures: S4 The patient is in a prone position. The longitudinal scale (2) of the device is aligned with the midline of the spine, the arrow points to the patient's head and is parallel to the ground, and the transverse slide rail is projected past the puncture point. S5 adjusts the transverse slide rail (1) so that the lateral distance is equal to the preoperatively planned s value; S6 swings the puncture cannula (3) to the transverse angle α, and rotates the turntable (5) to the sagittal angle β; S7 inserts the puncture needle along the puncture cannula (3) to a depth of z to complete the precise puncture.

7. The method according to claim 6, characterized in that: The medical imaging software used in step S2 is MIMICS 19.

0.

8. The method according to claim 6, characterized in that: In step S3, the cross-sectional angle α is the angle between the puncture needle in the cross-section and the midline of the spine, the sagittal angle β is the angle between the puncture needle in the sagittal plane and the vertical line to the ground, and the puncture depth z is the length of the puncture needle in the three-dimensional model.

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