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Year : 2020  |  Volume : 10  |  Issue : 1  |  Page : 43-48

Use of a low thermal injury dissection device reduces local tissue temperature change in a cadaveric model of anterior lumbar interbody fusion

1 Anterior Spine Institute for Research and Education (ASPIRE), Denver; Skyridge Medical Center, Lone Tree, CO, USA
2 Skyridge Medical Center, Lone Tree, CO, USA
3 Anterior Spine Institute for Research and Education (ASPIRE), Denver, CO, USA

Correspondence Address:
Dr. Michael A Gallizzi
10107 RidgeGate Pkwy, Evergreen Bldg Suite 370, Lone Tree, CO
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DORJ.DORJ_14_20

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Background Context: Local temperature change and thermal injury from electrosurgical instruments may be a source of complications in anterior lumbar interbody fusion (ALIF). Purpose: To determine if use of a low-thermal injury electrosurgical device affected changes in tissue temperature, depth of thermal injury, and incidence of electrical coaptations (arcs) in a cadaveric model of ALIF, compared to traditional electrosurgery. Study Design/Setting: Basic research study. Methods: Fiber optic temperature sensors were positioned percutaneously at the iliac artery, iliolumbar vein, sympathetic plexus, psoas muscle, illac vein, and aorta of four fresh, room temperature, cadaveric lumbar spine specimens. Traditional electrosurgery (ES) or a low thermal injury device (LTD) was used to perform a standard ALIF dissection. Change in tissue temperature at each anatomic point and the number of electrosurgical arcs to nearby retractors were recorded. Tissue samples at the temperature-monitoring points were harvested for histological analysis and measurement of depth of acute thermal injury. Results: Compared to electrosurgery, use of the LTD resulted in a meaningful and statistically significant reduction in temperature change at all anatomic measurement points except the aorta, and an overall 52% decrease in mean depth of thermal injury (0.14 ± 0.86 mm vs. 0.29 ± 0.17 mm, respectively; P = 0.0003). There were 95% fewer electrical arcs between LTD and retractors compared to ES (1 vs. 18 events; P = 0.0002). Conclusions: In a cadaveric model of ALIF, use of a low-thermal-injury electrosurgical device reduced local temperature change, depth of thermal injury, and the number of electrosurgical arcs compared to traditional electrosurgery.

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