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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 11, 1541-1544.
doi: 10.1302/0301-620X.91B11.22196  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Potential risk of thermal damage to cervical nerve roots by a high-speed drill

N. Hosono, MD, PhD, Chief Orthopaedic Surgeon1; T. Miwa, MD, Orthopaedic Surgeon1; Y. Mukai, MD, PhD, Orthopaedic Surgeon1; S. Takenaka, MD, Orthopaedic Surgeon1; T. Makino, MD, Orthopaedic Surgeon2; and T. Fuji, MD, PhD, Orthopaedic Surgeon1

1 Department of Orthopaedic Surgery Osaka Kosei-nenkin Hospital, Fukushima 4-2-78, Osaka 553-0003, Japan.
2 Department of Rehabilitation National Hospital Organisation, Osaka Minami Medical Centre, Kidohigashi 2-1, Kawachinagano, Osaka 586-8521, Japan.

Correspondence should be sent to Dr D. Hosono; e-mail: hosono-n{at}umin.net

Using the transverse processes of fresh porcine lumbar spines as an experimental model we evaluated the heat generated by a rotating burr of a high-speed drill in cutting the bone. The temperature at the drilled site reached 174°C with a diamond burr and 77°C with a steel burr. With water irrigation at a flow rate of 540 ml/hr an effective reduction in the temperature was achieved whereas irrigation with water at 180 ml/hr was much less effective. There was a significant negative correlation between the thickness of the residual bone and the temperature measured at its undersurface adjacent to the drilling site (p < 0.001).

Our data suggest that tissues neighbouring the drilled bone, especially nerve roots, can be damaged by the heat generated from the tip of a high-speed drill. Nerve-root palsy, one of the most common complications of cervical spinal surgery, may be caused by thermal damage to nerve roots arising in this manner.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General