Laser Osteotomy with Pulsed CO2 Lasers

Abstract

Non-contact laser osteotomy offers new opportunities in various surgical fields, since it allows very precise pre-programmed incisions with completely free geometry. However laser osteotomy is a demanding task, because bone is a tough composite material, which is at the same time a living tissue and sensitive to temperature increases. Besides thermal side effects, practical laser applicability was limited until now because of very low cutting rates and limited incision depths. We discuss how to overcome these disadvantages by means of an optimal arrangement of thermo-mechanical ablation with a pulsed CO2 laser and with a water-spray as an assisting media. To this arrangement belong optimal pulse duration, irradiance and radiant exposure of the laser pulses, as well as multi-pass cutting procedures. Effective ablation of hard bone tissue with minimal thermal damage is possible with relatively long CO2 laser pulses of 80 µs duration and an average laser power of up to 40 W. To overcome the depth limitation special scanning techniques, which allow deep incisions even in thick multi-layer bones in feasible irradiation times, were developed in our group.