Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device

Abstract

A technique for real-time dynamic monitoring of force experienced by a spinal needle during lumbar puncture using a fiber Bragg grating (FBG) sensor is presented. The proposed FBG force device (FBGFD) evaluates the compressive force on the spinal needle during lumbar puncture, particularly avoiding the bending effect on the needle. The working principle of the FBGFD is based on transduction of force experienced by the spinal needle into strain variations monitored by the FBG sensor. FBGFD facilitates external mounting of a spinal needle for its smooth insertion during lumbar puncture without any intervention. The developed FBGFD assists study and analysis of the force required for the spinal needle to penetrate various tissue layers from skin to the epidural space; this force is indicative of the varied resistance offered by different tissue layers for the spinal needle traversal. Calibration of FBGFD is performed on a micro-universal testing machine for 0 to 20 N range with an obtained resolution of 0.021 N. The experimental trials using spinal needles mounted on FBGFD are carried out on a human cadaver specimen with punctures made in the lumbar region from different directions. Distinct forces are recorded when the needle encounters skin, muscle tissue, and a bone in its traversing path. Real-time spinal needle force monitoring using FBGFD may reduce potentially serious complications during the lumbar puncture, such as overpuncturing of tissue regions, by impeding the spinal needle insertion at epidural space.

Fiber Bragg Gratings for Medical Applications and Future Challenges: A Review

“…Another function of the musculoskeletal system regards body stability. In this arena, FBGs-based systems were used to monitor intravertebral discs (IVDs) pressure [59]- [62]. The IVDs are the main joints of the spinal segment, and an understanding of the pressure distribution is an essential indicator of disc mechanics, injuries, and degeneration etiology.…”

“…The optical system exhibited good repeatability in monitoring pressure and an easier insertion than strain gauges, which often causes interferences with the vertebral endplates and potential damages. Also, the influence of the insertion depth and the diameter of the probe on the measured pressure was described in [61], [62]. The probe was constituted by two segments joined together by means of a bar with an FBG glued above.…”

Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation

“…Given the minute scale of retinal veins, between 30 and 400 µm, this is an extremely challenging task. Three key challenges can be associated with RVC: (1) guiding the needle to the target vein with an accuracy of 10 µm [23], (2) stopping at the proper depth when puncturing the vein and (3) maintaining the needle position during the injection [12]. Successfully performing these feats relies strongly on the surgeon's capacity to manage undesired hand motion-typically in the order of 300-400 µm [20]-as well as on the degree of local awareness of the target anatomy.…”

“…FBGs are adequately small sized (diameter of 60-200 µm), inherently safe, biocompatible, sterilizable, relatively inexpensive and highly sensitive. Their output is insulated from electrostatic and electromagnetic noise [1]. Several works in the literature describe how FBGs have been embedded in ophthalmological instruments [9,11,13,17,26].…”

3-DOF Force-Sensing Motorized Micro-Forceps for Robot-Assisted Vitreoretinal Surgery

“…FBG sensors, which are optical fibers that can detect fine changes in strain (less than 1 με ), have attained a rising interest in various medical applications for shape [66], force [67] and temperature [68] sensing purposes. They are very small in size (Ø 60–200 μ m), inherently safe, biocompatible, sterilizable, relatively inexpensive, and highly sensitive; furthermore, their output is immune from electrostatic and electromagnetic noise.…”