Abstract
Laser ablation of bone for the purposes of osteotomy is not as well understood as ablation of homogeneous, non-biological materials such as metals and plastics. Ignition times and etch rate can vary during ablation of cortical bone. In this study, we propose the use of two techniques to optimize bone ablation at 1064nm using a coaxial nitrogen jet as an assist gas and topical application of graphite as a highly absorbing chromophore. We show a two order of magnitude reduction in mean time to ignition and variance by using the graphite topical chromophore. We also show that an increase in volumetric flow rate of the assist gas jet does show an initial increase in etch rate, but increased pressure beyond a certain point shows decreased return. This study also demonstrates a 2 nd order relationship between exposure time, volumetric flow rate of nitrogen, and etch rate of cortical bone. The results of this study can be used to optimize the performance of laser ablation systems for osteotomy. This is a companion study to an earlier one carried out by Wong et al. [Biomedical Opt. Express6, 1 (2015)].
Highlights
Osteotomy is a highly mechanical process that makes use of tools that apply friction and torque to remove and re-shape bone during surgery
The results showed that the coagulation depth was dependant on laser dose, and it was claimed that the use of the carbon-based chromophores were effective
In this study we explore the increase in efficacy of bone ablation at 1064nm in the thermal regime using graphite as a topical chromophore
Summary
Osteotomy is a highly mechanical process that makes use of tools that apply friction and torque to remove and re-shape bone during surgery. Iatrogenic damage is an obvious concern, but in many situations it is considered ”part of the process” due to the forces transferred to surrounding areas during bone cutting. Despite care taken by the surgeon, peripheral damage is unavoidable. High risk osteotomies, such as craniotomies and laminectomies, would benefit from bone cutting modalities that reduce mechanical forces imparted onto the patient anatomy. Lasers, which have been extensively researched in bone cutting applications, are ideally suited for this task due to their precision and non-contact nature [1,2,3,4,5,6,7]
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