Potential risk of thermal damage to cervical nerve roots by a high-speed drill.
Using the transverse processes of fresh porcine lumbar spines as an experimental model we evaluated the heat generated by a rotating burr of a high-speed drill in cutting the bone. The temperature at the drilled site reached 174 degrees C with a diamond burr and 77 degrees C with a steel burr. With water irrigation at a flow rate of 540 ml/hr an effective reduction in the temperature was achieved whereas irrigation with water at 180 ml/hr was much less effective. There was a significant negative correlation between the thickness of the residual bone and the temperature measured at its undersurface adjacent to the drilling site (p < 0.001). Our data suggest that tissues neighbouring the drilled bone, especially nerve roots, can be damaged by the heat generated from the tip of a high-speed drill. Nerve-root palsy, one of the most common complications of cervical spinal surgery, may be caused by thermal damage to nerve roots arising in this manner.
Hosono
N
N
Department of Orthopaedic Surgery, Osaka Kosei-nenkin Hospital, Fukushima 4-2-78, Osaka 553-0003, Japan. hosono-n@umin.net
Miwa
T
T
Mukai
Y
Y
Takenaka
S
S
Makino
T
T
Fuji
T
T
D000818:Animals; D006358:Hot Temperature / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000601:surgery; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation*; D018570:Risk Assessment / Q000379:methods; D013126:Spinal Nerve Roots / Q000293:injuries*; D034421:Sus scrofa; D007507:Therapeutic Irrigation; D013997:Time Factors