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Deformed spinal needle tips and associated dural perforations examined by scanning electron microscopy
M J Jokinen1, M T Pitkänen, E Lehtonen
1Department of Anaesthesiology, Helsinki University Central Hospital, University of Helsinki, Finland.
Acta Anaesthesiologica Scandinavica
|July 1, 1996
Summary
Modern spinal needles are prone to tip damage from bone contact. Damaged needles create dural perforations that are not excessively torn, but may appear "open tin can"-like.
Area of Science:
- Neurosurgery
- Anesthesiology
- Medical Device Engineering
Background:
- Thin Quincke-type spinal needles are susceptible to bone-induced tip damage during procedures.
- This damage can potentially affect the integrity of dural perforations.
Purpose of the Study:
- To determine the frequency of spinal needle tip deformation in clinical practice.
- To evaluate the characteristics of dural perforations created by damaged spinal needles.
Main Methods:
- Inspection of 295 Quincke-type spinal needles (22G-29G) using light microscopy.
- Scanning electron microscopy (SEM) of damaged needle tips and experimental dural perforations.
Main Results:
- 4% of needle tips showed clear bending or hooking; 11% were slightly bent.
- Bone contact was associated with clear tip damage in 7% of cases; 99% were undamaged or slightly bent without bone contact.
- SEM revealed bent tips deviated 10-20 microns; dural perforations by bent tips were nearly closed, some with an 'open tin can' appearance.
Conclusions:
- Spinal needle tips are vulnerable to bone contact damage during routine use.
- Despite tip deformation, dural perforations do not appear severely torn, though morphology is altered.