Comparison of the Force Required for Dural Puncture with Different Spinal Needles and Subsequent Leakage of Cerebrospinal Fluid

Westbrook, Jonathan; Uncles, D. R.; Sitzman, B. Todd; Carrie, L.E.S.

doi:10.1213/00000539-199410000-00026

Cited by 61 publications

(34 citation statements)

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“…Needle insertion force affects the accuracy and eventually the duration of surgery [5]. A suitable and standard measurement procedure on the needle insertion force profile provides an accurate feasibility study on the usability of a needle guidance medical device.…”

Section: Introductionmentioning

confidence: 99%

Needle Insertion Forces Studies for Optimal Surgical Modeling

Ng¹,

Goh²,

Foo³

et al. 2013

IJBBB

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Abstract-Needle insertion for minimally invasive surgery is a technique explored and studied in order to adhere to the strict regulatory requirement for medical device development. While the instruments and techniques determine the success of every surgical procedure, minimal attention was given to the medium, the interaction force for testing, the development tools and surgical techniques. In this paper, we present the interaction forces involve during the needle insertion into porcine back tissue and simulated flesh-like tissue, independently measured by a testing setup developed for this purpose. The experimental setup and test procedure provides an understanding on the mechanics of needle insertion, potentially aid the design improvement on surgical instrument. Investigation on the composition of the force components helps to define the bio-mechanical properties of back abdomen tissue upon insertion. These forces comprises of stiffness, friction and cutting force. These results estimate the true insertion depth of the needle in the tissue. Needle insertion forces were measured for gelatine analogues developed to model the consistency of the tissues in the lumbar region of the back. This study was the first step in developing a force feedback controlled surgical instrument for needle insertion which will be used in kidney surgical operation.Index Terms-Needle insertion, insertion forces, porcine tissue and gelatine.

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Section: Introductionmentioning

confidence: 99%

Needle Insertion Forces Studies for Optimal Surgical Modeling

Ng¹,

Goh²,

Foo³

et al. 2013

IJBBB

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“…[11] There are many studies proving that blunt-tipped needles reduce the incidence of headache. [12][13][14][15] Westbrook et al [15] and Ready et al, [13] in their distinct studies with blunt-and sharp needles having the same outer diameter, found that CSF loss was less with blunt needles. Katı et al, [16,17] in a study with 60 patients, did not find any statistically significant difference between blunt and sharp needles with regard to headache.…”

Section: Discussionmentioning

confidence: 98%

“…In the studies with spinal anesthesia practices comparing the blunt needles and sharp needles with smaller diameter, it was reported that blunt needles were less likely to cause to headache. [13][14][15] Vascular penetration during invasive processes is a risk factor that may happen in all injection procedures. Potential complications of this situation are bleeding, hematoma formation, and intravascular drug injection.…”

Section: Discussionmentioning

confidence: 99%

Comparison Of Blunt And Sharp Needles For Transforaminal Epidural Steroid Injections

Özcan¹,

Şahín²,

Gurbet³

et al. 2012

Agri

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Özet Amaç SummaryObjectives: The aim of this study was to compare the sharp and blunt needles in order to determine the incidence of complications during transforaminal anterior epidural steroid injections. Methods: In this retrospective study, 185 cases that undergo transforaminal epidural steroid injection with sharp or blunt needles were evaluated between June 2004 and December 2008. Patients age, sex, diagnosis, needle type (sharp or blunt), volume of local anesthetic and steroid injected, complications (paresthesia, dural puncture, bleeding, paralysis, intravascular penetration, headache, local back pain, temporary motor loss in lower extremities) was recorded. Results: 3 cases in blunt needle group and 8 cases in sharp needle group showed paresthesia during the procedure. The difference was not found to be significant among the groups. Vascular penetration was observed in 2 cases in blunt and 13 cases in sharp needle group and the difference between groups was statistically significant (p<0.001). Dural puncture and headache incidence were not significant when the two groups are compared. The local back pain at the injection site had a higher incidence in the blunt needle group. Conclusion: When using the blunt needles, vascular penetration and paresthesia were less during transforaminal epidural steroid injections. Therefore blunt needles seem to be more advantageous.

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“…Since the needle cuts at an angle away from the direction of insertion, the needle may bend in the direction of the bevel. Past experiments have demonstrated the effect of tissue deformations due to rigid needle insertion [6]. Comparison between the tenderloin and sirloin porcine sample indicated that the deflection is different between the two porcine samples.…”

Section: A Porcine Specimen Testingmentioning

confidence: 98%

“…Needle deflection affects the accuracy and eventually the duration of surgery [6]. A suitable and standard measurement procedure on the needle deflection profile provides an accurate feasibility study on the usability of a needle guidance medical device.…”

Section: Introductionmentioning

confidence: 99%

Needle Deflection Studies for Optimal Insertion Modeling

Ng¹,

Goh²,

Foo³

et al. 2013

IJBBB

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Abstract-Needle insertion for minimally invasive surgery is a technique explored and studied for percutaneous procedure, diagnosis, localized therapeutic drug delivery, and Biopsy. While the instruments and techniques determine the success of every surgical procedure, minimal attention was given to the medium, the interaction between the tissue and the needle, the development tools and surgical techniques. This paper addresses the interaction by studying the needle deflection during the insertion into porcine back tissue and simulated flesh-like tissue. A customized testing setup is developed to measure and quantify these interactions. The needle deflection magnitude and its insertion characteristics were measured and correlated to define the bio-mechanical properties of back abdomen tissue upon insertion. Needle deflections were measured for gelatine analogues developed to model the consistency of the tissues in the lumbar region of the back. This study was the first step in developing a deflection feedback controlled surgical instrument which enable the needle to reach its intended target in the percutaneous operation. The experimental setup and test procedure provides an understanding on the mechanics of needle insertion, potentially aid the design improvement on surgical instrument.Index Terms-Needle insertion, needle deflection, porcine tissue and gelatine.

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Comparison of the Force Required for Dural Puncture with Different Spinal Needles and Subsequent Leakage of Cerebrospinal Fluid

Cited by 61 publications

References 0 publications

Needle Insertion Forces Studies for Optimal Surgical Modeling

Needle Insertion Forces Studies for Optimal Surgical Modeling

Comparison Of Blunt And Sharp Needles For Transforaminal Epidural Steroid Injections

Needle Deflection Studies for Optimal Insertion Modeling

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