Grant: Operating Grant

The purpose of this research is to develop an innovative, robust, intuitive and affordable system for guiding needle insertion into the lumbar spine. Ultrasound imaging will be the basis for guidance before and during needle insertion. The main application is facet joints and epidural/steroid injection for the relief of chronic back pain, and labour/analgesia. The anesthesiologist is expected to use the system to choose a suitable puncture location, insert the needle at an appropriate angle and stop when the needle reaches the desired depth. The goal is to increase the confidence level by enabling an accurate needle placement on the first attempt, and hence reduce complications and pain for the patient. In current practice, the needle insertion is either done blindly, using palpation to choose a puncture site, or under fluoroscopy/CT guidance, which carry a high radiation dose risk to both patient and anesthesiologist. We will develop and validate a system that adds real-time ultrasound capability to these procedures by using an augmented reality environment that displays the ultrasound, pre-procedure CT and needle trajectory to the anesthesiologist. The system will integrate new ways of aligning ultrasound images with pre-procedure data in an innovative guidance interface for the anesthesiologist to interpret the images and relate them to the patient's anatomy. This includes incorporation of spine statistical atlas information. The tools and techniques will be validated in a number of patient studies. The proposed system is timely as ultrasound has enjoyed a recent resurgence for spinal needle placement among clinicians. The development of the system will uniquely combine recent technological and medical advancements at the University of British Columbia and University of Western Ontario, and their affiliated hospitals, on image-guided interfaces for needle placement in the lumbar spine.