The present invention relates to a puncture needle for injecting bone cement into the interior of a bone, as well as to a method for producing the same.
Percutaneous vertebral body plasty is a therapeutic method in which a vertebral body is reinforced by injecting bone cement into a damaged portion of the vertebral body for the purpose of removing pain arising from a compression fracture of the vertebral body. In recent years, percutaneous vertebral body plasty, which is a comparatively new therapeutic method that was carried out for the first time in France in 1987, has been practiced also in many institutions in Japan.
Percutaneous vertebral body plasty is basically a trans-pedicular approach in which a puncture needle of a hollow structure is made to puncture a vertebral body via pedicles located to the left and right on the back side of the vertebral body. Bone cement is injected into the vertebral body through an injection passage in the puncture needle. A bone biopsy needle is generally used as the puncture needle for injection of bone cement (see, for example, Japanese Laid-Open Patent Publication No. 2003-024339). The trans-pedicular approach includes a two-needle method, in which puncturing is conducted from both left and right sides, and a one-needle method, in which puncturing is conducted from only one side.
The one-needle method is advantageous over the two-needle method because it enables a reduction in cost, alleviation of complications, a reduction in the exposure dose, and shortening of the procedure time. On the other hand, there is a problem in that, when bone cement is injected by a conventional one-needle method, the internal pressure in the bone is raised accompanying injection of the bone cement, which may lead to leakage of bone cement to a location outside of the bone (for example, into the vertebral lumen or vein).
In order to solve such a problem, in International Publication No. WO 2010/044462, a puncture needle is proposed for injecting bone cement, in which an outer needle has a double-tube structure consisting of an inner tube and an outer tube. A first side hole is provided in the vicinity of a distal end portion of the outer tube, and a second side hole is provided in the vicinity of a proximal end portion of the outer tube. According to the puncture needle for injecting bone cement constituted in the foregoing manner, upon injection of bone cement into the bone through a hollow portion of the outer tube, gas or liquid (e.g., exudate or blood) is allowed to enter into a depressurization passage via the first side hole, whereupon the gas or liquid is discharged to the exterior of the living body via the second side hole. Consequently, it is possible to prevent the internal pressure inside the bone from rising due to injection of bone cement, as well as to prevent bone cement from leaking out to the exterior of the bone.
Meanwhile, in the case that an outer needle base is provided on a proximal end portion (base portion) of the outer needle, which is provided with a side hole therein, similar to the puncture needle for injecting bone cement according to the aforementioned International Publication No. WO 2010/044462, it may be contemplated to form the outer needle base by insert molding. In this case, it is necessary to provide a countermeasure against generation of closure or deformation of the side hole during insert molding.
The present invention has been made taking into consideration the aforementioned circumstances. Accordingly, it is an object of the present invention to provide a puncture needle for injecting bone cement, in which an outer needle base can be formed by insert molding without inducing closure or deformation of a side hole, as well as to a method for producing the same.
In order to attain the above object, according to the present invention there is provided a puncture needle for injecting bone cement into the interior of a bone, including an outer needle of a hollow structure and having a bone cement passage therein, an outer needle base fixed to a proximal end portion of the outer needle and formed by insert molding, a side port-forming member embedded in the outer needle base, an inner needle having a cutting edge at a distal end thereof, and which is inserted and passed in a hollow portion of the outer needle in a slidable manner, and an inner needle base secured to a proximal end portion of the inner needle. The outer needle includes a first side hole located on an outer circumferential portion in the vicinity of a distal end portion thereof, a second side hole located on an outer circumferential portion in the vicinity of the proximal end portion thereof, and a depressurization passage, which is independent from the bone cement passage, and which provides communication between the first side hole and the second side hole. The side port-forming member covers a circumference of the second side hole and provides communication between the second side hole and a location outside of the outer needle base.
According to the aforementioned constitution, the second side hole, which is provided on the proximal end portion of the outer needle, is covered by the side port-forming member, and the outer needle base is formed so as to cover the side port-forming member. Therefore, during molding of the outer needle base, the outer needle base can be insert-molded without causing closure or deformation of the second side hole.
In the aforementioned puncture needle for injecting bone cement, preferably, the side port-forming member includes a connecting section in which the outer needle is inserted, and a hollow port body section extending outwardly from a side portion of the connecting section, the second side hole confronts a proximal-end-side opening of the port body section, and the proximal-end-side opening of the port body section is greater than the second side hole.
According to the aforementioned constitution, the proximal-end-side opening of the port body section is greater than the second side hole. This ensures that during the production process, the second side hole can be placed so as to confront the proximal-end-side opening, without requiring accurate positional adjustment of the proximal-end-side opening and the second side hole. Thus, the position adjusting operation can be simplified.
In the aforementioned puncture needle for injecting bone cement, preferably, the side port-forming member includes a connecting section in which the outer needle is inserted, and a hollow port body section extending outwardly from a side portion of the connecting section, the connecting section is provided on an inner circumferential portion with a groove extending in a circumferential direction, and the second side hole confronts the port body section or the groove.
According to the aforementioned constitution, at a time of inserting the proximal end portion of the outer needle into the side port-forming member during a production process, there is no need for positional adjustment in the circumferential direction of the proximal-end-side opening of the port body section and the second side hole. Accordingly, the insertion operation can be simplified.
In the aforementioned puncture needle for injecting bone cement, preferably, a bulge-forming member, which bulges from an outer circumferential surface of the outer needle in order to make a cross sectional profile orthogonal to an axis of the outer needle non-circular, is secured to the outer needle, and the bulge-forming member is embedded in the outer needle base.
According to the aforementioned constitution, the bulge-forming member secured to the cross sectional profile of the outer needle is non-circular. Therefore, relative rotation of the outer needle and the outer needle base can be prevented from occurring, even if a high torque is exerted between the outer needle and the outer needle base. In addition, the bulge-forming member can prevent the outer needle from slipping out in a distal end direction from the outer needle base.
In the aforementioned puncture needle for injecting bone cement, preferably, the bulge-forming member is formed from a member that is C-shaped in cross section and extends along an axial direction of the outer needle. End portions of the C-shaped form of the bulge-forming member and an outer circumferential portion of the outer needle are joined together along the axial direction of the outer needle.
The bulge-forming member constituted in the foregoing manner is C-shaped in cross section, which makes it possible to easily make the cross sectional profile thereof non-circular. In addition, since joint parts are provided along the end portions of the C-shaped form, the bulge-forming member can be firmly secured to the outer needle.
In the aforementioned puncture needle for injecting bone cement, preferably, the bulge-forming member is formed from a tubular member the cross sectional profile of which is non-circular.
According to the aforementioned constitution, the bulge-forming member can be constituted using a simple tubular member. In addition, it is possible to easily provide a structure that bulges from an outer circumferential surface, and which makes the cross sectional profile orthogonal to the axis of the outer needle non-circular.
In the aforementioned puncture needle for injecting bone cement, preferably, the bulge-forming member is disposed more toward a distal end side of the outer needle than the side port-forming member.
According to the aforementioned constitution, the bulge-forming member is provided at a position on the outer needle base that is near the distal end side of the outer needle. At such a position, separation of the outer needle base and the outer needle is inhibited. Therefore, separation can be effectively prevented from spreading to the proximal end side of the outer needle base. Accordingly, relative rotation of the outer needle and the outer needle base can reliably be prevented.
In the aforementioned puncture needle for injecting bone cement, preferably, a flange part formed by plastic working is provided on a proximal end portion of an outer tube constituting the outer needle, and a projection, which is formed by plastic working and makes a cross sectional profile orthogonal to an axis of the outer tube non-circular, is provided on an outer circumferential portion of a part of the outer tube, the part being embedded in the outer needle base and located on a distal end side relative to the flange part.
According to the aforementioned constitution, using the flange part, it is possible to prevent the outer needle from slipping out in the distal end direction of the outer needle base. In addition, the projection that makes the cross-sectional profile non-circular ensures that relative rotation of the outer needle and the outer needle base can be prevented from occurring, even if a high torque is exerted between the outer needle and the outer needle base. Further, since the flange part and the projection are formed by subjecting the outer tube to plastic working, the structure for preventing slipping-out and rotation can easily be provided without the need for any additional component parts.
In the aforementioned puncture needle for injecting bone cement, preferably, the projection is provided more toward a distal end side of the outer needle than the side port-forming member.
According to the aforementioned constitution, the projection is provided at a position in the outer needle base, which is near the distal end side of the outer needle. Also, at such a position, mutual separation of the outer needle base and the outer needle from each other is inhibited. Therefore, separation can be prevented from spreading to the proximal end side of the outer needle base. Accordingly, relative rotation of the outer needle and the outer needle base can be prevented more securely.
In the aforementioned puncture needle for injecting bone cement, preferably, the side port-forming member is composed of a transparent member.
According to the aforementioned constitution, when liquid that has flowed out of a bone flows into the side port-forming member, the liquid inside the side port-forming member can visually be confirmed from outside the side port-forming member. Thus, flowing-out of liquid from the bone can be visually checked at an early time, which contributes to smooth progress of the injection technique.
In addition, according to the present invention, there is provided a method for producing a puncture needle for injecting bone cement into the interior of a bone, wherein the method includes a securing step in which a hollow side port-forming member having a side port at a distal end thereof is secured to a proximal end portion of a tubular member, so as to cover a circumference of a second side hole, the tubular member including a hollow portion that penetrates in an axial direction thereof, a first side hole provided on an outer circumferential portion in the vicinity of a distal end portion thereof, the second side hole provided on an outer circumferential portion in the vicinity of the proximal end portion thereof, and a depressurization passage, which is independent from the hollow portion, and which provides communication between the first side hole and the second side hole. The method also includes an outer needle base-forming step for forming, by insert molding, an outer needle base that covers the side port-forming member as well as the proximal end portion of the tubular member.
Herein, the above-mentioned tubular member is a concept, which includes not only an outer needle formed into a finished shape, but also an intermediate product prior to forming the outer needle into the finished shape. In the embodiments, the term “double-tube member” corresponds to such an intermediate component part.
According to the aforementioned production method, the outer needle base is insert-molded after the second side hole has been covered by the side port-forming member. Therefore, the outer needle base can be insert-molded without causing closure or deformation of the second side hole.
In the method of producing a puncture needle for injecting bone cement, preferably, in the securing step, the side port-forming member and the tubular member are adhered to each other by a heat-resistant adhesive.
By using a heat-resistant adhesive in this manner, securing of the side port-forming member and the outer tube to each other can be maintained assuredly, since the adhesive properties of the adhesive are not lost even if the adhesive is exposed to heat during insert molding of the outer needle base.
In the aforementioned method for producing a puncture needle for injecting bone cement, preferably, the side port-forming member is composed of a transparent member, and the securing step further includes a step of applying a UV (ultraviolet)-curable adhesive between the side port-forming member and the tubular member, and a step of irradiating the applied UV-curable adhesive with UV rays in order to cure the UV-curable adhesive.
By using a UV-curable adhesive in this manner, it is possible for the side port-forming member and the tubular member to be secured to each other in a short time.
In the aforementioned method for producing a puncture needle for injecting bone cement, preferably, the method further includes a bulge-adding step in which a bulge-forming member for making a cross sectional profile orthogonal to an axis of the tubular member non-circular is secured to an outer tube constituting the tubular member. Further, in the outer needle base forming step, the outer needle base is formed so as to cover the bulge-forming member.
According to the aforementioned constitution, the cross-sectional profile is made non-circular by adding the bulge-forming member to the outer tube. This ensures that relative rotation of the outer needle and the outer needle base can be prevented from occurring, even if a high torque is exerted between the outer needle and the outer needle base. In addition, due to the bulge-forming member, it is possible to prevent the outer needle from slipping out in the distal end direction of the outer needle base.
In the aforementioned method for producing a puncture needle for injecting bone cement, preferably, the method further includes a flange part-forming step in which a flange part is formed by plastic working on a proximal end portion of an outer tube constituting the tubular member, and a projection-forming step in which a projection, which makes a cross sectional profile orthogonal to an axis of the outer tube non-circular, is formed by plastic working on an outer circumferential portion on a distal end side relative to the proximal end portion of the outer tube. Further, in the outer needle base-forming step, the outer needle base is formed so as to cover the flange part and the projection.
According to the aforementioned method, the flange part makes it possible to prevent the outer needle from slipping out in the distal end direction of the outer needle base. In addition, the projection, which makes the cross-sectional profile non-circular, ensures that relative rotation of the outer needle and the outer needle base can be prevented from occurring, even if a high torque is exerted between the outer needle and the outer needle base. Further, since the flange part and the projection are formed by subjecting the outer tube to plastic working, the structure for preventing slippage and rotation can easily be provided without the need for any additional component parts.
According to the puncture needle of the present invention for injecting bone cement, together with the method for producing the same, the second side hole, which is provided on the proximal end portion of the outer needle, is covered by the side port-forming member, and the outer needle base is formed so as to cover the side port-forming member. Therefore, during a procedure of molding the outer needle base, the outer needle base can be insert-molded without causing closure or deformation of the second side hole.
Preferred embodiments of a puncture needle for injecting bone cement according to the present invention will be described below with reference to the attached drawings. Incidentally, the term “bone cement” as used herein includes not only bone cement (plastic products, etc.) but also bone paste (calcium phosphate products, etc.).
As shown in
In the following description, an axial direction of the inner needle 14 and the outer needle 12 will be referred to as a Z-direction, a direction perpendicular to the Z-direction and in which the outer needle base 16 extends will be referred to as an X-direction, and a direction perpendicular to the Z-direction and the X-direction will be referred to as a Y-direction. In
The outer needle 12 is a member having a hollow structure and which is open at both ends thereof. The outer needle 12 includes an inner tube 22 through which the inner needle 14 is inserted and passed, and an outer tube 24 that surrounds the inner tube 22. Thus, the outer needle 12 is of a double-tube structure. A sharp cutting edge 13 is formed on the distal end of the outer needle 12.
The material forming the inner tube 22 and the outer tube 24 is not particularly limited, insofar as the material has appropriate strength, so as not to become broken or deformed at times of puncturing a bone or upon withdrawal from a bone. Examples of suitable materials include stainless steel, aluminum alloys, and copper alloys.
As shown in
The inner tube 22 is composed of an inner tube section 28 constituting an inner tube wall of the double-tube structure, and a tip 30 provided on a distal end portion of the inner tube section 28. The tip 30 is greater in diameter than the inner tube section 28. A proximal end portion 22a of the inner tube 22 is enlarged in diameter, and is supported by an inner circumferential surface of a proximal end portion 24a of the outer tube 24.
The outer tube 24 opens at both ends thereof, and permits the inner tube 22 to be inserted in the hollow portion thereof. The length of the outer tube 24 is about 100 to 200 mm, and is shorter than the inner tube 22 by the length of the tip 30. The outer tube 24 is a hollow cylindrical tube. An inside diameter d2 of the outer tube 24 is greater than an outside diameter d1 of the inner tube section 28 (except for the proximal end portion 22a thereof). A depressurization passage 32, which extends in the axial direction, is formed between the outer tube 24 and the inner tube section 28. The inside diameter of the outer tube 24, for example, is about 1.9 to 3.2 mm.
A distal end portion of the outer tube 24 is secured to the tip 30 of the inner tube 22, for example, by welding or the like, such that the depressurization passage 32 is closed on the distal end side thereof. In a condition in which the proximal end portion 22a of the inner tube 22 is supported by the inner circumferential part of the proximal end portion 24a of the outer tube 24, the proximal end portion 22a of the inner tube 22 and the proximal end portion 24a of the outer tube 24 overlap with each other in secure contact, whereby the depressurization passage 32 is closed on the rear end side.
The outer tube 24 is provided with a first side hole 34 in the vicinity of a distal end portion thereof. The first side hole 34 is a hole that penetrates through the outer tube 24 from the inside to the outside thereof. Preferably, plural holes are arranged both in the circumferential direction and in the axial direction. The number of the first side holes 34 preferably is 4 to 36, and more preferably, is 10 to 26.
The distance L1 from a distal-most end position of the outer needle 12 to the first side hole 34 located on the most proximal end side (more specifically, to the proximal-most end part of the first side hole 34 in consideration) is set such that, in a condition in which a bone is punctured by the outer needle 12, the first side hole 34 on the most proximal end side is not located outside of the bone, namely, all of the first side holes 34 are located within the bone. More specifically, the distance L1 is equal to or less than 20 mm, and more preferably, is equal to or less than 15 mm.
The first side holes 34 are not necessarily all of the same size, but may be of different sizes. For instance, when a cleaning device is connected to a side port 42 for cleaning the inside of a bone, in order to ensure that the amount of cleaning liquid jetted from the proximal end side of the first side hole 34 in proximity to the side port 42 will not exceed the amount of liquid jetted from the first side hole 34 on the distal end side, the diameters of the side holes located more on the distal end side may be greater. The shapes of the first side holes 34 are not necessarily circular but, for example, may be elliptical or polygonal in shape. In addition, differently shaped first side holes 34 may be provided in combination.
The size of the first side holes 34 is preferably set to permit gas or liquid (for example, an exudate or blood) in the bone to flow smoothly into the outer needle 12. If the first side holes 34 are circular in shape, the diameter thereof preferably is about 0.3 to 0.7 mm. If the first side holes 34 are non-circular in shape, the size at a narrowest portion thereof preferably is about 0.3 to 0.7 mm.
If the first side holes 34 are too small, liquid from inside the bone will easily lead to clogging of the first side holes 34. However, if the lower limit of the size of the first side holes 34 is set as mentioned above, liquid from inside the bone does not easily plug up or clog the first side holes 34. If the size of the first side holes 34 is too large, puncture resistance tends to increase, thereby decreasing the smoothness with which techniques can be performed using the puncture needle. However, if the upper limit of the size of the first side holes 34 is set as mentioned above, an increase in puncture resistance can be restrained.
The outer tube 24 is provided with a second side hole 36 in the vicinity of a proximal end portion thereof. The second side hole 36 is a hole that penetrates through the outer tube 24 from the inside to the outside thereof. The shape of the second side hole 36 is not necessarily circular, but may be, for example, elliptical or polygonal in shape.
The size of the second side hole 36 is preferably set so as to permit gas or liquid (for example, exudate or blood) in the bone to smoothly flow out from the depressurization passage 32. If the second side hole 36 is circular in shape, the diameter thereof preferably is about 1.0 to 2.0 mm. If the second side hole 36 is non-circular in shape, the size at a narrowest portion thereof preferably is about 1.0 to 2.0 mm.
The distance L2 from the distal-most end position of the outer needle 12 to the second side hole 36 (more specifically, to a portion on the most distal end side (Z1-direction side) of the second side hole 36) is set so that, when a bone is punctured by the puncture needle 10, the second side hole 36 is located assuredly outside of the living body. More specifically, the distance L2 is equal to or greater than 80 mm, and more preferably, is equal to or greater than 100 mm.
While only one second side hole 36 is provided in the exemplary constitution shown in
The side port-forming member 18 is formed so as to cover the circumference of the second side hole 36, and to provide communication between the second side hole 36 and the exterior of the outer needle base 16. More specifically, the side port-forming member 18 includes a connecting section 38 in which the outer needle 12 is inserted, and a hollow port body section 40 that extends outwardly (in the X2-direction) from a side portion of the connecting section 38.
The connecting section 38 has a hollow cylindrical shape, the inner diameter of which is approximately equal to the outside diameter of the outer tube 24. An inner circumferential surface of the connecting section 38 and an outer circumferential surface of the outer needle 12 (outer tube 24) are adhered to each other by means of an adhesive. The second side hole 36 confronts a proximal-end-side opening 40a of the port body section 40. The inside diameter of the proximal-end-side opening 40a of the port body section 40 preferably is greater than the second side hole 36. For example, the inside diameter is about 1.5 to 5.0 mm. The inside diameter of the hollow portion of the port body section 40 may be constant along the axial direction, or may become enlarged in diameter in a direction toward the distal end side.
A distal end portion of the side port-forming member 18 is constituted as the side port 42, which protrudes from the outer needle base 16, and to which another device or structure can be attached in a detachable manner. An outer circumferential portion of the side port 42 is formed with a male screw part 42a thereon, which is capable of being screw-engaged with another device or structure.
The material for forming the side port-forming member 18 is not particularly limited. Examples of suitable materials include polyvinyl chloride, polyethylene, polypropylene, cyclic polyolefins, polystyrene, poly(4-methylpentene-1), polycarbonates, acrylic resins, acrylonitrile-butadiene-styrene copolymer, polyesters such as polyethylene terephthalate, polyethylene naphthalate, etc., butadiene-styrene copolymer, and polyamides (for example, nylon 6, nylon 6·6, nylon 6·10, and nylon 12).
The outer needle base 16 is a member that is connected to a proximal end portion of the outer needle 12, and functions as a grip, which can be gripped by a user of the puncture needle 10. The outer needle base 16 is formed by insert molding, so as to cover the proximal end portion of the outer needle 12 as well as the side port-forming member 18. The material for forming the outer needle base 16 is not particularly limited. For example, the material can be selected from among the same materials that were mentioned above as materials for forming the side port 42. The materials forming the outer needle base 16 and the side port 42 are not necessarily the same, but may be different materials.
The outer needle base 16 is formed to protrude (extend) to both sides in a direction (X-direction) perpendicular to the axis of the outer needle 12, and the aforementioned side port 42 that opens at the longitudinally-directed one end portion of the outer needle base 16. A passage 44, which communicates with the bone cement passage 26 in the outer needle 12, is formed in the outer needle base 16. A main port 46 to which the inner needle base 20 is connected is provided at one end portion in the Z2-direction of the outer needle base 16. A hollow portion of the main port 46 constitutes part of the passage 44. A male screw part 44a for detachable engagement with a bone cement injector (for example, a syringe), and which is provided with a lock, is formed on an outer circumferential portion of the main port 46.
In addition, as will be described later, the main port 46 also functions as a receptacle, which is connected to the puncture needle 10 of a syringe for supplying bone cement to the puncture needle 10.
As shown in
The outside diameter of the inner needle 14 preferably is approximately equal to the inside diameter of the outer needle 12 (the inside diameter of the inner tube 22). More specifically, the outside diameter of the inner needle 14 preferably is set such that the inner needle 14 can be smoothly inserted into the bone cement passage 26, which forms the hollow portion (lumen) of the outer needle 12, and so that substantially no gap is generated between the outer circumference of the inner needle 14 and the inner circumference of the outer needle 12 (the inner circumference of the inner tube 22).
The length of the inner needle 14 is set such that the distal end of the inner needle 14 protrudes slightly from the distal end of the outer needle 12, in a condition in which the inner needle base 20 is connected to the outer needle base 16. In such a condition, in which the inner needle base 20 is connected to the outer needle base 16, a cutting edge surface 15a of the cutting edge 15 of the inner needle 14 is flush with a cutting edge surface 13a of the cutting edge 13 of the outer needle 12. In this manner, the cutting edges 13 and 15 of the outer needle 12 and the inner needle 14 jointly constitute a needle tip 47 of the puncture needle 10.
The inner needle base 20 constitutes a member that is connected to a proximal end portion of the inner needle 14. The outside diameter of the inner needle base 20 is greater than the outside diameter of the inner needle 14. More specifically, the outside diameter of the inner needle base 20 is set so that the inner needle base 20 can easily be pinched with the fingers, and be pushed, pulled and rotated by the user (a health care staff member, such as a doctor or the like). The material that forms the inner needle base 20 is not particularly limited. As suitable materials, materials can be used which are the same as or similar to those for the outer needle base 16. For instance, hard resins such as polycarbonate can be used.
As shown in
The engaging grooves 52a and 52b are provided in a side wall that forms a recess 54 of the outer needle base 16, in a state of extending in the thickness direction of the outer needle base 16 (Y-direction). One end on the X2-direction side of the engaging groove 52a is located substantially in the center in the thickness direction of the outer needle base 16, whereas the other end thereof opens on a side surface on one side (Y1 side) of the outer needle base 16. One end of the engaging groove 52b on the X1-direction side is located substantially in the center in the thickness direction of the outer needle base 16, whereas the other end thereof opens on a side surface on the other side (Y2 side) of the outer needle base 16.
The lock mechanism 48 is constituted as described above. Accordingly, when the inner needle base 20 is placed in engagement with the outer needle base 16 for thereby connecting the inner needle base 20 to the outer needle base 16, relative rotation of the inner needle base 20 and the outer needle base 16 causes the projection bodies 50a and 50b to become engaged with the engaging grooves 52a and 52b, respectively. In this instance, the cutting edge surface 15a of the cutting edge 15 of the inner needle 14 and the cutting edge surface 13a of the cutting edge 13 of the outer needle 12 become flush with each other and are maintained in this state.
During injection of bone cement into a bone by use of the puncture needle 10, which is constituted in the foregoing manner, first, a puncture position and a puncture target are determined under imaging-based guidance (i.e., under fluoroscopy or under CT). Thereafter, the puncture needle 10 with the inner needle 14 attached thereto is hit with a hammer, in order to cause the puncture needle 10 to puncture the bone at the puncture target. In this case, the objective bone is a vertebra, for example.
Incidentally, before puncturing a patient using the puncture needle 10, a procedure may be performed in which a tube for supplying a cleaning liquid is connected to the main port 46, whereupon the cleaning liquid is supplied through the passage 44 into the bone cement passage 26 of the outer needle 12 to thereby clean the bone cement passage 26. Similarly, a procedure may be carried out in which a tube for supplying a cleaning liquid is connected to the side port 42, whereupon the cleaning liquid is supplied through the hollow portion of the port body section 40 and the second side hole 36 into the depressurization passage 32 formed between the outer tube 24 and the inner tube section 28.
After the puncture target has been punctured by the puncture needle 10, the inner needle 14 is pulled out from the outer needle 12. In this instance, the first side holes 34 are located within the bone, whereas the second side hole 36 is located outside of the living body.
Next, a syringe filled with bone cement is attached to the main port 46 of the outer needle base 16, whereupon the bone cement in the syringe is injected into the bone through the passage 44 and the bone cement passage 26. In this instance, gas or liquid (for example, exudate or blood) in the bone can enter the depressurization passage 32 through the first side holes 34, so as to be discharged from the living body through the second side hole 36. Thus, the internal pressure inside the bone can be prevented from being raised as a result of injection of the bone cement. Therefore, the bone cement can be prevented from leaking out to the exterior of the bone.
Incidentally, if the side port-forming member 18 is formed from a transparent material (for example, polycarbonate), when liquid that flows out from inside the bone flows into the side port-forming member 18 (i.e., the side port 42), it is possible to visually confirm the interior liquid from outside of the side port-forming member 18. Therefore, flowing out of liquid from inside the bone can be confirmed at an early time, which enables the technique to be performed smoothly. If a suction device is connected to the side port 42, whereby discharging of gas or liquid from inside the depressurization passage 32 is aided, rising of the internal pressure inside the bone can be prevented more effectively.
After the bone cement in the syringe has been injected in a required amount, the syringe is detached. Then, the inner needle 14 is inserted into the passage in the outer needle base 16 and into the bone cement passage 26 of the outer needle 12, whereby bone cement remaining in the passage and the bone cement passage 26 is pushed out into the bone.
In percutaneous vertebral body plasty, in the event that a plurality of puncture needles 10 are used for injecting bone cement, plural puncture needles 10 for injecting bone cement are made to puncture a patient's body, in such a manner that the outer needle bases 16 thereof are arranged mutually in parallel. If the side ports 42 are provided at longitudinally-directed end portions of the outer needle bases 16, as in the puncture needle 10 according to the present embodiment, the side ports 42 of the adjacent puncture needles 10 do not obstruct each other, so that the procedure can be carried out smoothly.
Next, a method for producing the puncture needle 10 constituted in the foregoing manner will be described below. Primarily, a step of forming the outer needle base 16 by insert molding will be described in detail below, whereas other steps will only be described briefly.
A step of forming the outer needle base 16 at a proximal end portion of the outer needle 12 is carried out by insert molding in the following manner. A double-tube member (tubular member) 58, as shown in
Next, a securing step is conducted in which the side port-forming member 18 is secured to a proximal end portion of the double-tube member 58, so as to cover the circumference of the second side hole 36. More specifically, as shown in
After the proximal end portion of the double-tube member 58 has been inserted into the connecting section 38 of the side port-forming member 18, an adhesive is applied between the connecting section 38 and the double-tube member 58. Thereafter, the applied adhesive is cured, thereby connecting the side port-forming member 18 and the double-tube member 58 to each other. In this case, it is preferable for a heat-resistant adhesive to be used, so that the adhesive properties of the adhesive are not lost or deteriorated by heat during insert molding, which is carried out at a later time. In this case, the heat resistance temperature of the heat-resistant adhesive must be equal to or greater than the temperature (for example, 200° C.) of the molten resin that is injected when insert molding is performed. Examples of suitable heat-resistant adhesives include epoxy adhesives and ceramic adhesives.
A UV-curable adhesive may be used as the adhesive that connects the side port-forming member 18 and the double-tube member 58. More specifically, a process may be adopted in which a UV-curable adhesive is applied between the side port-forming member 18 and the double-tube member 58, whereupon the applied UV-curable adhesive is cured by irradiating the UV-curable adhesive with UV rays. In this case, the side port-forming member 18 may be composed of a transparent member (for example, a polycarbonate having excellent transparency), whereby the UV-curable adhesive can be irradiated with UV rays that are transmitted through the side port-forming member 18. By use of a UV-curable adhesive, it is possible to secure the side port-forming member 18 and the double-tube member 58 to each other in a short time.
Subsequently, as shown in
Next, as shown in
The cutting edge surfaces 13a, 15a may be formed by subjecting the distal ends of the rod-shaped member 60 and the double-tube member 58 to cutting edge surface-forming polishing prior to forming the inner needle base 20 and the outer needle base 16 by insert molding. Alternatively, the rod-shaped member 60 and the double-tube member 58 may be subjected to cutting edge surface-forming polishing simultaneously, after formation of the inner needle base 20 and the outer needle base 16 by insert molding. Further, alternatively, the rod-shaped member 60 and the double-tube member 58 may be subjected to cutting edge surface-forming polishing simultaneously, after the inner needle base 20 is connected to the outer needle base 16, as shown in
While a preferred embodiment of the present invention has been described above, the invention is not limited to the above embodiment, and it is a matter of course that various alternative arrangements are possible within the scope of the present invention.
For instance, in a side port-forming member 18a according to the modification shown in
If such a groove 62 is provided, even in the event that the side port-forming member 18a is fixed to the outer needle 12 in a condition in which the second side hole 36 is located so as to confront the groove 62, and hence does not confront the hollow portion of the port body section 40, it can be ensured that the second side hole 36 communicates with the hollow portion of the port body section 40 through the groove 62. Therefore, when the proximal end portion of the double-tube member 58 is inserted into the side port-forming member 18a in the production process, it is unnecessary to carry out positional adjustment of the second side hole 36 and the proximal-end-side opening 40a of the port body section 40 in the circumferential direction. Accordingly, the insertion operation can be simplified.
In the case that the side port-forming member 18a formed with the groove 62 therein is adopted, a plurality of second side holes 36 may be provided along the circumferential direction, as shown in
In the puncture needle 10 according to the above-described embodiment, the side port 42 is provided on a longitudinally-directed end portion of the outer needle base 16. However, in a puncture needle 10A for injecting bone cement according to the modification shown in
In the puncture needle 10 according to the above-described embodiment, the outer needle 12 has a constitution in which the outer tube 24 and the inner tube 22 having the tip 30 at its distal end are welded together. However, the outer needle 12 having such a constitution may be replaced by an outer needle having a constitution in which the outer tube is provided at the distal end thereof with a tapered section, such that the distal end of the inner tube is supported by an inner circumferential portion of the tapered section.
The puncture needle 10a differs from the puncture needle 10 according to the first embodiment in that a bulge-forming member 70 is secured to an outer circumferential surface of an outer needle 12. The bulge-forming member 70 is a member that bulges from an outer circumferential surface of the outer needle 12 (outer tube 24), and which makes the cross sectional profile orthogonal to the axis of the outer needle 12 non-circular. The bulge-forming member 70 is embedded in an outer needle base 16. As shown in
End portions of the C-shaped form of the bulge-forming member 70 and an outer circumferential portion of the outer needle 12 are joined together by joint parts 72, which extend along the axial direction of the outer needle 12. The junction between the bulge-forming member 70 and the outer needle 12 can be provided by any appropriate joining means, such as welding, soldering, adhesion or the like. In the case of the present embodiment, the bulge-forming member 70 is C-shaped in cross section, such that the joint parts 72 can be provided along the axial direction of the outer needle 12. Accordingly, it is possible to secure a large junction area and thus easily obtain a sufficient joint strength.
Knurling (a multiplicity of mountain-shaped projections) 74 is provided on an outer circumferential portion of the bulge-forming member 70. Incidentally, such knurling 74 need not necessarily be provided over the entire outer circumferential portion of the bulge-forming member 70, but may be provided only on a part of the outer circumferential portion.
Meanwhile, it is necessary to prevent the outer needle 12 from slipping out from the outer needle base 16 due to forces that are exerted when the puncture needle 10a, in a state of puncturing a bone, is pulled out from the bone. In addition, it is necessary to prevent the outer needle 12 and the outer needle base 16 from being rotated relative to each other due to a torque, which is exerted when the puncture needle 10a, in a state of puncturing a bone, is rotated. In the case of a puncture needle having a single-tube structure, as in the related art, the outer needle has ample material thickness. Therefore, when a projection or projections (ribs or the like) are formed integrally on an outer circumferential portion of the outer needle by cutting or the like, the projection or projections make it possible comparatively easily to prevent the outer needle from slipping out or from being rotated.
However, in the case of an outer needle 12 having a double-tube structure, in certain cases, the outer tube 24 of the outer needle 12 cannot be provided with sufficient material thickness. Therefore, it is difficult to form a projection or projections on the outer circumferential portion of the outer tube 24 by cutting or the like. In view of this drawback, the puncture needle 10a according to the present embodiment is provided with the bulge-forming member 70, which is secured to an outer circumferential portion of the outer needle 12. According to the puncture needle 10a having such a constitution, the bulge-forming member 70, which is secured to the outer needle 12, is non-circular in cross-section. This ensures that, even if a high torque is exerted between the outer needle 12 and the outer needle base 16, the outer needle 12 and the outer needle base 16 can be prevented from rotating relative to one another. In addition, the bulge-forming member 70 can prevent the outer needle 12 from slipping out in the distal end direction of the outer needle base 16.
Further, in the present embodiment, the bulge-forming member 70 is C-shaped in cross section and extends along the axial direction of the outer needle 12. In addition, end portions of the C-shaped form of the bulge-forming member 70 and the outer circumferential portion of the outer needle 12 are joined together along the axial direction of the outer needle 12. Therefore, since the bulge-forming member 70 constituted in this manner is C-shaped in cross section, the cross sectional profile thereof can easily be made non-circular. In addition, since the joint parts 72 are provided along end portions of the C-shaped form, the bulge-forming member 70 can be secured firmly to the outer needle 12.
Next, a method for producing the puncture needle 10a according to the present embodiment will be described below. To produce the bulge-forming member 70, initially, a hollow cylindrical member that serves as a base material for the bulge-forming member 70 is prepared. Knurling is formed on an outer circumferential portion of the hollow cylindrical member, whereby the molded article 76 shown in
As shown in
Next, a securing step is conducted in which the side port-forming member 18 is secured to a proximal end portion of the double-tube member 58 so as to cover the circumference of the second side hole 36. More specifically, initially, as shown in
As shown in
Subsequently, the outer needle base 16 is formed by insert molding so as to cover the side port-forming member 18 and the bulge-forming member 70, as well as the proximal end portion of the double-tube member 58. As a result, the outer needle 12 and the outer needle base 16 are produced, as shown in
The bulge-forming member 70 shown in
In this manner, by providing a member which, when provided on the outer circumferential portion of the outer needle 12, makes the cross sectional profile orthogonal to the axis of the outer needle 12 non-circular, relative rotation of the outer needle 12 and the outer needle base 16 can be prevented. Further, based on such a concept, the following second to sixth modifications can also be contemplated.
As shown in
As shown in
According to a fourth modification shown in
As shown in
As shown in
Incidentally, in the second embodiment, components, which are provided in common with the first and second embodiments, can naturally exhibit operations and effects which are the same or similar as the operations and effects of such common parts in the first embodiment.
In the puncture needle 10a according to the second embodiment, the side port-forming member 18a, as shown in
The puncture needle 10b differs from the puncture needle 10 according to the first embodiment in that the puncture needle 10b has an outer tube 24b (outer needle 12b), which is provided with a flange part 92 and a projection 94, in contrast to the puncture needle 10 having the outer tube 24 (outer needle 12) lacking such a flange part and a projection. As shown in
The flange part 92 is a part that bulges radially outward in a ring-like shape at the proximal end portion of the outer tube 24b, which is formed by plastic working. The flange part 92 can be formed, for example, by bending using a press. The outside diameter of the flange part 92 is greater than the inside diameter of a connecting section 38 of the side port-forming member 18. The flange part 92 is placed in abutment with the upper end of the connecting section 38.
The projection 94 is a part that is formed on an outer circumferential portion located more toward the distal end side of the outer tube 24b than the flange part 92, and the projection 94 is embedded in the outer needle base 16. The projection 94 makes the cross sectional profile orthogonal to the axis of the outer tube 24b non-circular, and the projection 94 is formed by plastic working. Formation of the projection 94 can be carried out by coining, for example. Coining ensures that a minute projection 94 (a projection having a height of about 100 μm, for example) can be formed on an outer circumferential portion of the outer tube 24b, even in cases where the material thickness of the outer tube 24b is quite small.
Incidentally, although the size of the projection 94 is exaggerated in
In the case of the exemplary constitution shown in the figures, a plurality of such projections 94 is formed on the outer circumferential portion of the outer tube 24b at intervals along the circumferential direction. Although it suffices to provide at least one projection 94, it is preferable for a plurality of such projections to be provided, as in the exemplary constitution shown in the figures. The projection 94 is not limited to being one that extends along the axial direction of the outer tube 24b, but a projection may be provided that is inclined relative to the axial direction. For example, a spiral projection may be adopted.
With the puncture needle 10b according to the present embodiment and constituted as described above, the flange part 92 makes it possible to prevent the outer needle 12b from slipping out in the distal end direction of the outer needle base 16. In addition, the projection 94, which makes the cross sectional profile non-circular, makes it possible to prevent relative rotation of the outer needle 12b and the outer needle base 16, even if a high torque is exerted between the outer needle 12 and the outer needle base 16. Further, since the flange part 92 and the projection 94 are formed by subjecting the outer tube 24b to plastic working, the structure for preventing slippage and rotation can easily be provided, without the need for additional component parts.
In the puncture needle 10b according to the present embodiment, the projection 94 is provided more on the distal end side of the outer needle 12b than the side port-forming member 18, such that the projection 94 is provided at a position on the outer needle base 16 which is nearer to the distal end side of the outer needle 12b. Therefore, at this position, separation of the outer needle base 16 and the outer needle 12b from each other is inhibited, and separation can effectively be prevented from spreading toward the proximal end side of the outer needle base 16. Consequently, relative rotation of the outer needle 12b and the outer needle base 16 can more securely be prevented.
Next, a method for producing the puncture needle 10b according to the present embodiment will be described below. As shown in
Then, as shown in
Subsequently, a securing step is conducted in which the side port-forming member 18 is secured to a proximal end portion of the double-tube member 58b in order to cover the circumference of the second side hole 36. More specifically, as shown in
As shown in
Next, the outer needle base 16 is formed by insert molding, so as to cover the side port-forming member 18 together with the flange part 92 and the projection 94 of the outer tube 24b, as well as the proximal end portion of the double-tube member 58b. As a result, the outer needle 12 and the outer needle base 16 are produced, as shown in
Incidentally, in the third embodiment, components thereof, which are in common with components of the first embodiment, can naturally exhibit the same or similar operations and effects as the operations and effects of the common components in the first embodiment.
In the puncture needle 10b according to the third embodiment, the side port-forming member 18a shown in
Number | Date | Country | Kind |
---|---|---|---|
2010-217843 | Sep 2010 | JP | national |
2011-069646 | Mar 2011 | JP | national |
Number | Date | Country | |
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Parent | PCT/JP2011/071069 | Sep 2011 | US |
Child | 13852727 | US |