Efficiency and Heat Production of Ultrasonic Osteotome Strategy in Robot-Assisted Laminectomy

Global Spine J. 2024 Nov 7:21925682241300457. doi: 10.1177/21925682241300457. Online ahead of print.

Abstract

Study design: A biomechanical study.

Objective: We aimed to assess temperature fluctuations when applying the ultrasonic osteotome during laminectomy and identify the most appropriate cutting method for robot-assisted laminectomy to mitigate the risk of heat-related injuries.

Methods: Utilizing a robotic system for laminectomy, the study implemented the ultrasonic bone scalpel to cut both artificial polyurethane bones and animal spinal bones. The research focused on comparing and analyzing the maximum temperature of the inner surface of four types of artificial bones through three different cutting techniques: vertical constant cutting at speeds of .5 mm/s and 1 mm/s, as well as robot-assisted vertical reciprocating cutting. After the initial results, two optimal vertical cutting approaches were selected for subsequent trials, evaluating the effectiveness and temperature impact of various ultrasonic osteotome modes on 10 isolated spinal bones from pigs.

Results: When cutting polyurethane bones, reciprocating cutting demonstrated the lowest maximum temperature in contrast to constant speed cutting at .5 mm/s and 1 mm/s. In the animal bone trial, direct cutting registered an average maximum temperature of 43.25°C with an average cutting duration of 688.3 s, while reciprocating cutting recorded an average maximum temperature of 34.20°C with an average cutting time of 713.0 s.

Conclusions: The reciprocating cutting strategy utilized in robot-assisted ultrasonic osteotome is effective in reducing heat generation and maintaining high cutting efficiency.

Keywords: cutting strategy; maximum temperature; robotic spinal surgery; ultrasonic osteotome.