Spray-Irrigation System Attached to High-Speed Drills for Simultaneous Prevention of Local Heating and Preservation of a Clear Operative Field in Spinal Surgery

Abstract

Heat generation due to drilling during spinal surgery is potentially hazardous to nerves. Saline irrigation is often performed to prevent such local heating, but sometimes floods and obscures the operative field. We have developed a spray-irrigation system for attachment to high-speed drills, which sprays saline solution with an air-jet in the direction of the surface cut by the drill. We anticipated that this air jet would create a clearer operative view by displacing excess fluid, and would also provide an added cooling effect greater than that of irrigation with saline. This study was designed to evaluate these predicted effects of the spray-irrigation system compared to conventional irrigation. A thermography study was performed to confirm the cooling effect of the spray-irrigation system. A plaster board coated with adhesives was drilled at 100,000 rpm along a 10-cm line for a duration of 20 seconds. Thermograms were recorded every minute, without cooling, with irrigation, and with the spray-irrigation system. To examine the operative views, continuous drilling for a period of seconds was performed with conventional irrigation and with the spray-irrigation system. Local heating was inhibited by the spray-irrigation system to 14-30% of that with irrigation. A clear operative field was maintained during continuous drilling using the spray-irrigation system through the air-jet action of the system. The spray-irrigation system can simultaneously provide effective cooling and a clear operative field during surgical manipulations with high-speed drills.

Fluid Lubrication and Cooling Effects in Diamond Grinding of Human Iliac Bone

“…It is considered to be a method that enables fine work in an environment where thermal damage is not to occur and may contribute to improving surgical outcomes [ 29 ]. Under the microscope, a mist irrigation system has been developed, and the operator’s spraying of water and the cooling action of the nitrogen gas injection contribute to improving the safety in addition to cleaning the operative field [ 30 ].…”

Comprehensive analysis on orthopedic drilling: A state-of-the-art review

“…Spray irrigation allowed limited generation of heat and chip clogging. 100 The authors have related this low-temperature elevation under spray irrigation with the evaporation produced by the cooling phenomenon and kept the cortical bone temperature lower. Isler et al 101 compared the effect of saline irrigation temperature (4°C and 25°C) on the healing of the bone.…”

Effect of irrigation technique on the vertebral canal temperature during thoracolumbar hemilaminectomy in dogs: An ex vivo study

“…9,10 Temperature elevation in nervous tissue and resultant thermal injury has been extensively investigated with ex vivo studies, experimental animal models, and in vivo studies. [10][11][12][13][14][15][16][17][18][19][20][21] Uchiyama and others evaluated the effect of temperatures ranging from 43 to 47 C for 30 min duration on canine spinal cords using spinal cord evoked potentials and histopathology. 22 The main findings of their study were: (1) full functional recovery with no histologic changes was noted at 44 C for 30 min, (2) at 45 C for 30 min, although all dogs had a full functional recovery histological changes (pigment exudation, vacuolation, and hemorrhage) were noted, and (3) temperature ≥46 C for 30 min caused tissue destruction in all dogs with incomplete to no functional recovery.…”