Chen Allen, Nanda Udai, Solberg Joseph, Rand Ethan, Christolias George, Singh Jaspal Ricky
Department of Orthopaedic Surgery, University of California - Los Angeles, Los Angeles, CA, USA.
Department of Physical Medicine and Rehabilitation, Veterans Health Administration, Los Angeles, CA, USA.
Interv Pain Med. 2024 Jul 31;3(3):100429. doi: 10.1016/j.inpm.2024.100429. eCollection 2024 Sep.
Percutaneous pain and spine procedures play an important diagnostic and therapeutic role in the treatment of various pain diagnoses. Accurate placement of needles or cannulae during these procedures is paramount to the success of these procedures.
The purpose of this study is to examine and quantify the amount of deflection of radiofrequency cannulae based on curved tip versus no curved tip, using a ballistic gel tissue simulant.
Six different types of cannulae commonly used for spinal and peripheral nerve ablations were selected, including 18, 20, and 22 gauge curved and straight radiofrequency cannulae. Ballistic gel samples were made in molds of 40 mm and 80 mm. Each cannula was mounted in a drill press to ensure accurate trajectory.
Curved RFA cannula had increased deflection when compared to straight cannula for 18-, 20-, and 22-gauge cannulae at a depth of 40 mm. Curved RFA cannula had increased deflection when compared to straight cannula for 20- and 22-gauge cannulae at a depth of 80 mm. Overall, the mean deflection for a curved cannula increased 1.9x for 20-gauge cannulae and 2.5x for 22-gauge cannulae when compared to a straight cannula.
For interventionalists, understanding the effects of needle or cannula shape is crucial for accurate placement. When a procedure requires additional steerability, additional deflection up to 2.5x obtained by placing a bend in the needle or cannula tip should be considered.
经皮疼痛和脊柱手术在各种疼痛诊断的治疗中发挥着重要的诊断和治疗作用。在这些手术过程中，针或套管的准确放置对于手术的成功至关重要。
本研究的目的是使用弹道凝胶组织模拟物，检查并量化基于弯曲尖端与无弯曲尖端的射频套管的偏转量。
选择六种常用于脊柱和周围神经消融的不同类型的套管，包括18号、20号和22号弯曲和直型射频套管。在40毫米和80毫米的模具中制作弹道凝胶样本。将每个套管安装在钻床上以确保轨迹准确。
在40毫米深度时，18号、20号和22号弯曲射频套管与直型套管相比，偏转增加。在80毫米深度时，20号和22号弯曲射频套管与直型套管相比，偏转增加。总体而言，与直型套管相比，20号弯曲套管的平均偏转增加1.9倍，22号弯曲套管的平均偏转增加2.5倍。
对于介入医生来说，了解针或套管形状的影响对于准确放置至关重要。当手术需要额外的可操纵性时，应考虑通过在针或套管尖端设置弯曲获得高达2.5倍的额外偏转。
