CN103705300A

CN103705300A - Lumbar puncture needle for radio frequency target spot thermocoagulation therapy

Info

Publication number: CN103705300A
Application number: CN201410017594.7A
Authority: CN
Inventors: 高尚明; 赵晓峰; 王云龙
Original assignee: Huaian No 1 Peoples Hospital
Current assignee: Huaian No 1 Peoples Hospital
Priority date: 2014-01-15
Filing date: 2014-01-15
Publication date: 2014-04-09

Abstract

The invention discloses a lumbar puncture needle for radio frequency target spot thermocoagulation therapy. The lumbar puncture needle comprises a needle point (1), a needle body (2) and a needle tail (3), and the needle point (1), the needle body (2) and the needle tail (3) are integrally formed to form the lumbar puncture needle. The lumbar puncture needle is characterized in that the needle point (1) is in a flat arc shape, and is blunt; the needle body (2) is circular; the needle tail (3) is square, and is provided with an injector connector (4); a longitudinal needle hole (5) penetrates through the needle tail (3) and extends to the needle point (1) along the needle body (2), the arc of the tail end of the needle hole (5) stretches out of the back face of the needle point (1), and the stretching point of the needle hole is 2.5-3.5mm away from the tail end of the needle point. The lumbar puncture needle is simple in structure and convenient to operate, a radio frequency needle can reach the protruding intervertebral disc safely, the dural sac or the cauda equine or the nerve root or the large intraspinal blood vessel cannot be hurt, the safety performance is high, and the good therapeutic effect on large herniation is achieved.

Description

Radio frequency target spot coagulation treatment heat lumbar puncture needle

Technical field

The present invention relates to medical apparatus and instruments, be specifically related to a kind of lumbar puncture needle of radio frequency target spot coagulation treatment heat prolapse of lumbar intervertebral disc.

Background technology

Prolapse of lumbar intervertebral disc is a kind of commonly encountered diseases, frequently-occurring disease that has a strong impact on human health.Current Therapeutic Method is a lot, as acupuncture, massage, physical therapy, pin cutter, surgical operation, interventional therapy etc.Above-mentioned Therapeutic Method cuts both ways, and with regard to comprehensive therapeutic effect, operating curative effect is the most sure, but surgery operating wound is large, risk height is its shortcoming.Along with scientific and technical development, and people are more and more higher to healthy requirement, and the interventional therapy method of Wicresoft is little with its wound, good effect, and sequela obtains affirming of more and more experts and patient's welcome less.In numerous Wicresoft's interventional therapeutic techniques, radio frequency target spot heat setting technology is the new technique that development in recent years is swift and violent.It is under the guidance location of C type arm X-ray machine, the triangle of safety district of the little arthritis medial border in the trocar of Gent system hole between sour jujube (posterior approach) or neuropore (side approach) to be punctured to the target spot (seeing Fig. 1) of Lumbar intervertebral disc protrusion, from the trocar, insert working electrode, select the electric current of proper strength, can make the electric discharge of the end of working electrode heat up, thereby the Lumbar intervertebral disc protrusion of target spot place certain limit is melted, by human body natural, absorb, thereby remove Lumbar intervertebral disc protrusion to the compressing of nerve root (seeing Fig. 2).

(1) posterior approach treatment: from the other facet joint medial border inserting needle of opening about 1.0cm of responsibility intervertebral space, be mainly used in partially osculant outstanding; (2) side approach surgical treatment: open 8 ~ 10cm from responsibility intervertebral space side, district enters canalis spinalis through neuropore triangle of safety, is mainly used in the outstanding of inclined to one side lateral.Above-mentioned treatment is made target spot radio frequency electrical to outstanding intervertebral disc and is melted, and does not destroy vertebral body structure, does not damage the tissues such as the outer muscular fascia of vertebral body, and clinical total curative effect is better, has certain safety, but there are the following problems:

1, electrode sleeve bobbin wear out dural sac cause cerebrospinal leak and damage cauda equina nerve.

2, due to patient's individual variation and the difference of doctors experience level, the above-mentioned trocar is not often once just can puncture and put in place, need under C type arm X-ray machine, constantly adjust, in the damage of dural sac and cauda equina nerve damage and nerve root and canalis spinalis, the damage probability of trunk can be larger like this.

If 3 outthrust often need to carry out greatly the treatment of posterior approach and side approach simultaneously, increased like this operational risk.Especially side approach, long because of puncture path, risk is larger.

4, be that posterior approach or side approach arrive the general each target spot (a plurality of target spot operational risks obviously increase as punctured) of all just making a call in outstanding position.It (is to consider from security standpoint that the temperature of damaging in view of radio-frequency electrode and scope have certain limitation, to avoid adjacent nerve root, the damage of dural sac as far as possible), therefore, if when outthrust is larger, the effect of above-mentioned treatment is limited, and patient often needs to use instead additive method treatment.

5, outstanding intervertebral disc is sometimes close to dural sac and is even oppressed distortion, and while making target spot radio-frequency (RF) therapy, the risk that next-door neighbour's dural sac is accidentally injured obviously increases, once damage will cause serious consequence.

Summary of the invention

The object of the invention is to: a kind of radio frequency target spot coagulation treatment heat lumbar puncture trocar is provided, the present invention is simple in structure, easy to operate, makes the radio frequency needle outstanding intervertebral disc that arrives safe and sound, do not damage dural sac and cauda equina nerve, larger giving prominence to also had to good curative effect.

Technical solution of the present invention is: this lumbar puncture needle comprises needle point, needle body and backshank, and needle point, needle body and the backshank Trinity become lumbar puncture needle;

Needle point is flat camber, and needle point is more blunt; Needle body is circular; Backshank is square, backshank band syringe interface; Longitudinal type pin hole penetrates along needle body and extends to needle point from backshank, and pin hole end circular arc passes at the needle point back side, and the exit points of pin hole is apart from tip end 2.5-3.5mm.

During use, by proper method by lumbar puncture needle percutaneous puncture the front lateral border to canalis spinalis dural sac, arrive outstanding intervertebral disk hernia place; Through pin hole, insert radio-frequency electrode needle cannula to outstanding target spot again, finally by radio-frequency electrode needle cannula electrode insertion, treat.

The present invention has the following advantages:

1, make the radio frequency needle outstanding intervertebral disc that arrives safe and sound, do not damage dural sac and cauda equina nerve;

2, electrode sleeve bobbin, as do not put in place by one-time puncture, can not cause damage to trunk in dural sac, cauda equina nerve, nerve root or canalis spinalis in position adjustment;

3, no matter outstanding intervertebral disc is inclined to one side central type or lateral partially, or the two has concurrently, all only need be through the posterior approach pin that punctures;

4, one-time puncture can carry out many target treatments, in target spot adjustment process, to dural sac, nerve and trunk not damaged, larger giving prominence to is also had to good curative effect;

While 5, making target spot radiofrequency ablation therapy, can effectively separate target spot and dural sac, even if target spot and dural sac are adjacent very near, the risk that also can effectively avoid dural sac to be accidentally injured.

Accompanying drawing explanation

Ji little joint, Tu1Wei triangle of safety district inner edge Puncture approach schematic diagram.

Fig. 2 is that radio frequency target spot coagulation treatment heat is removed the compressing signal picture of Lumbar intervertebral disc protrusion to nerve root.

fig. 3 is that the master of lumbar puncture needle of the present invention looks schematic diagram.

Fig. 4 is the schematic rear view of Fig. 3.

Fig. 5 is the main schematic diagram of looking in needle point position of the lumbar puncture needle of Fig. 3.

Fig. 6 is the schematic side view of Fig. 5.

Fig. 7 is the needle handle schematic diagram of the lumbar puncture needle of Fig. 3.

Fig. 8 is the syringe interface schematic diagram of the lumbar puncture needle of Fig. 3.

Fig. 9 is the longitudinal type pin hole schematic diagram of the lumbar puncture needle of Fig. 3.

Figure 10 is that lumbar puncture needle arc outwards thrusts until facet joint photo from fixed point place.

To be puncture needle needle point slowly softly move to facet joint medial border needle point along facet joint to Figure 11 to the inside breaks through ligamenta flava and enter canalis spinalis signal picture.

Figure 12 is that the flat needle point of passivity slips over dural sac lateral margin along canalis spinalis sidewall forward security and enters the side crypts in its side the place ahead and arrive outstanding intervertebral disc signal picture.

Figure 13 is that the radian of needle point turns to inner side, rear, the puncture that arc needle point has reached outside, Lumbar intervertebral disc protrusion before the dural sac schematic diagram sheet that puts in place.

Figure 14, for when radio-frequency electrode is worked, guarantees that its heat radiation can not form the signal picture of accidentally injuring to dural sac.

Figure 15 is to central type, partially central type and the outstanding treatment of lateral and two target spots many target treatments schematic diagram even partially.

In figure: 1 needle point, 2 needle bodies, 3 backshanks, 4 syringe interfaces, 5 pin holes.

The specific embodiment

As shown in Figure 3,4, this lumbar puncture needle comprises needle point 1, needle body 2 and backshank 3, and needle point 1, needle body 2 and backshank 3 Trinity become lumbar puncture needle; As shown in Figure 5,6, needle point 1 is flat camber, and needle point is more blunt; As shown in Figure 7, needle body 2 is circular; As shown in Figure 8, backshank 3 is square, backshank 3 band syringe interfaces 4; As shown in Figure 9, longitudinal type pin hole 5 penetrates along needle body 2 and extends to needle point 1 from backshank 3, and pin hole 5 end circular arcs pass at needle point 1 back side, and the exit points of pin hole is apart from tip end 2.5-3.5mm.

Wherein, lumbar puncture needle is as follows for the process of radio frequency target spot coagulation treatment heat prolapse of lumbar intervertebral disc:

(1) patient gets ventricumbent position, and abdomen underlay is high medicated pillow suitably, and about 1.0cm fixed point is opened on responsibility intervertebral space side;

(2) local anaesthesia is steadily rear with opening sword-shaped needle prick skin and deep fascia, first with pin lancination, enter to facet joint, further cut on the one hand the Musclar layer under deep fascia, verify on the other hand position, scope and the facet joint medial border (the namely lateral border in hole between sour jujube) of facet joint;

(3) lumbar puncture needle arc is outside, thrust until facet joint at fixed point place certainly, as shown in figure 10;

(4) puncture needle needle point is slowly softly moved to facet joint medial border to the inside along facet joint, slightly firmly have the sense of breakthrough, this breaks through ligamenta flava for needle point and enters canalis spinalis; Because needle point is passivity, the dural sac at ligamenta flava rear has certain mobility to dodge voluntarily, generally can not be punctured, as shown in figure 11;

(5) from the syringe connector access syringe of backshank, make gas injection, flood-pot experiment, with clear and definite needle point, do not enter in dural sac;

(6) continue inserting needle, because the arcuate directions of the arc of needle point and canalis spinalis sidewall approaches, so the flat needle point of passivity can be along canalis spinalis sidewall forward, and safety slip is crossed dural sac lateral margin and entered the side crypts in its side the place ahead and arrive outstanding intervertebral disc, as shown in figure 12;

(7) hand-held needle handle, does 180 degree rotations by the needle body, makes the radian of needle point turn to inner side, and now arc needle point has reached the front outside of dural sac, and the rear of Lumbar intervertebral disc protrusion confirms that through C type arm x-ray puncture puts in place, as shown in figure 13;

(8) again by syringe, make gas injection, water injection test, confirm that puncture needle is not in dural sac, pin hole from puncture needle backshank inserts radio-frequency electrode sleeve pipe to target spot, because puncture needle pinhole openings is in the dorsal part of arc needle point, therefore, can guarantee that radio frequency needle walks around dural sac and arrive treatment target spot and can not damage dural sac and cauda equina nerve;

(9), from radio-frequency electrode sleeve pipe electrode insertion, start the treatment of normal procedure; Because puncture needle front end is flat, effectively separated dural sac and treatment target spot, therefore, when radio-frequency electrode is worked, guarantee that its heat radiation can not form and accidentally injure dural sac, reduces Operative risk, as shown in figure 14.

The needle point of puncture needle is passivity, therefore, needle point is in dural sac front side, the rear side of intervertebral disc is suitably mobile and can not injure dural sac, nerve root or large blood vessel, like this, position and the angle by suitable adjustment needle tip realize the outstanding of inclined to one side central type and the outstanding treatment of lateral partially; More even can many target treatments as outthrust, one-time puncture, realizes two even many target treatments of target spot, as shown in figure 15.

Claims

1. the radio frequency target spot coagulation treatment heat lumbar puncture trocar, this lumbar puncture needle comprises needle point (1), needle body (2) and backshank (3), needle point (1), needle body (2) and backshank (3) Trinity become lumbar puncture needle; It is characterized in that: needle point (1) is flat camber, and needle point is more blunt; Needle body (2) is circular; Backshank (3) is square, backshank (3) band syringe interface (4); Longitudinal type pin hole (5) penetrates along needle body (2) and extends to needle point (1) from backshank (3), and pin hole (5) end circular arc passes at needle point (1) back side, and the exit points of pin hole is apart from tip end 2.5-3.5mm.