Project Description:

Lumbar punctures (LPs) are essential diagnostic and therapeutic procedures performed daily by advanced practice providers (APPs), with over 350,000 being performed in the U.S. each year. Despite their frequency, APPs currently rely primarily on tactile palpation of spinal landmarks to guide needle insertion, with miss rates approaching 50% on the first attempt. Miss rates are also substantially higher in patients with BMI >30 or underlying spinal deformities such as scoliosis. Multiple failed attempts not only increase the risk of traumatic LPs and post-dural puncture headaches but also prolong procedure time, elevate provider stress, and contribute to patient discomfort. When bedside attempts fail, radiology consultation is often required, delaying diagnosis and extending hospital stays.

To address these challenges, we developed a sterile, disposable device that integrates seamlessly with modern ultrasound probes to provide real-time, image-guided needle trajectory support. The device incorporates a manually rotatable needle-guidance track whose angle is continuously captured by an onboard microcontroller. This angle data is converted into a visual overlay on the ultrasound display, enabling providers to visualize the predicted needle trajectory. The guidance track is open at one end, allowing the device and ultrasound probe to be removed once the needle is placed, giving providers full manual control for subsequent steps of the procedure while maintaining sterility.

In benchtop testing using a lumbar puncture simulation model, our system achieved successful CSF acquisition within two attempts in 81.5% of trials, compared to 55% using conventional tactile technique alone. These results underscore the device’s potential to reduce procedural attempts, improve safety, and enhance overall efficiency. By combining disposable sterility, intuitive ultrasound integration, and precise trajectory visualization, our device aims to make puncture-perfect LPs achievable across diverse clinical populations.