Annu Int Conf IEEE Eng Med Biol Soc. 2022 Jul;2022:4391-4396. doi: 10.1109/EMBC48229.2022.9871709.
A computed tomography (CT)-guided robotic assistance system is useful for needle insertion into metastatic carcinoma of vertebrae, which has limited pathways. However, the use of conventional needles in this procedure can result in bone fracture in the perforation area caused by the reaction force of the inserted needle. In this study, we developed a multistage retractable needle guide unit that avoids the buckling and crushing of the needle tip that commonly occur in 25-gauge ultrafine needles. First, we clarified a relationship between the shape of the guide and the termination factor when a buckling load is applied to the needle. Next, we revealed the point at which the plastic deformation of the needle occurred when the bone is drilled. Based on these results, we developed a guide unit with the reaction force set to an appropriate value. Finally, an evaluation test of bone needle insertion was conducted on porcine vertebrae with using the developed needle guide unit equipped with a 25-gauge needle. The needle penetrated the vertebra without buckling or crushing of the needle tip, which demonstrates the value of this multistage retractable needle guide unit when ultrafine needles are required. Clinical Relevance- Cancer tumors often metastasize to bones. There is a treatment called percutaneous vertebroplasty which restores the patient's quality of life by injecting poly (methyl methacrylate) (PMMA) into a bone. It helps to reinforce the bone that has become brittle due to cancer metastasis to the vertebral body or osteoporosis. This treatment often involves puncture of the vertebrae but the limited puncture pathway makes it difficult to perform the treatment manually. Therefore it is necessary to construct a system that supports accurate puncture by a robot such as the proposed method.
计算机断层扫描（CT）引导机器人辅助系统对于进入有限入路的转移性椎体癌的穿刺非常有用。然而，在该手术中使用常规穿刺针会导致因插入针的反作用力而在穿孔区域发生骨折。在本研究中，我们开发了一种多节可回缩的穿刺针导针器，可避免 25 号超细针常见的针尖弯曲和压溃。首先，我们阐明了当施加弯曲载荷时，导针形状与终止因子之间的关系。接下来，我们揭示了在骨钻孔时针发生塑性变形的点。基于这些结果，我们开发了一种将反作用力设置为适当值的导针器。最后，在配备有 25 号针的开发的穿刺针导针器上对猪的椎骨进行了骨穿刺评估试验。穿刺针未弯曲或压溃针尖，证明了在需要使用超细针时，这种多节可回缩穿刺针导针器的价值。临床相关性-癌症肿瘤通常转移到骨骼。有一种治疗方法称为经皮椎体成形术，通过向骨骼中注射聚甲基丙烯酸甲酯（PMMA）来恢复患者的生活质量。它有助于强化因癌症转移到椎体或骨质疏松症而变得脆弱的骨骼。这种治疗通常涉及椎体穿刺，但有限的穿刺路径使得手动操作变得困难。因此，有必要构建一个系统，例如所提出的方法，以支持机器人进行精确穿刺。
