J Korean Neurosurg Soc.  2016 Nov;59(6):559-563. 10.3340/jkns.2016.59.6.559.

Temperature Distributions of the Lumbar Intervertebral Disc during Laser Annuloplasty : A Cadaveric Study

• Lee MH
• Kim IS
• Hong JT
• Sung JH
• Lee SW
• Kim DH

• KMID: 2417336
• DOI: http://doi.org/10.3340/jkns.2016.59.6.559

Abstract

OBJECTIVE
Low back pain, caused intervertebral disc degeneration has been treated by thermal annuloplasty procedure, which is a non-surgical treatement. The theoretical backgrounds of the annuloplasty are thermal destruct of nociceptor and denaturization of collagen fiber to induce contraction, to shrink annulus and thus enhancing stability. This study is about temperature and its distribution during thermal annuloplasty using 1414 nm Nd : YAG laser.
METHODS
Thermal annuloplasty was performed on fresh human cadaveric lumbar spine with 20 intact intervertebral discs in a 37℃ circulating water bath using newly developed 1414 nm Nd : YAG laser. Five thermocouples were attached to different locations on the disc, and at the same time, temperature during annuloplasty was measured and analyzed.
RESULTS
Thermal probe's temperature was higher in locations closer to laser fiber tip and on lateral locations, rather than the in depth locations. In accordance with the laser fiber tip and the depth, temperatures above 45.0℃ was measured in 3.0 mm depth which trigger nociceptive ablation in 16 levels (80%), in accordance with the laser fiber end tip and laterality, every measurement had above 45.0℃, and also was measured temperature over 60.0℃, which can trigger collagen denaturation at 16 levels (80%).
CONCLUSION
When thermal annuloplasty is needed in a selective lesion, annuloplasty using a 1414 nm Nd : YAG laser can be one of the treatment options.

Keyword

Low back pain; Intervertebral disc degeneration; Temperature; Nd : YAG laser

MeSH Terms

Baths
Cadaver*
Collagen
Humans
Intervertebral Disc Degeneration
Intervertebral Disc*
Lasers, Solid-State
Low Back Pain
Nociceptors
Spine
Water
Collagen
Water

Figure

• 

  Fig. 1 The apparatus used in the experiment. Using the above apparatus, experiments were conducted at a constant temperature (A : 1414 nm Nd : YAG laser system, B : thermal data loader, C : heating probe and circulating system, D : water bath, E : thermometer).

• 

  Fig. 2 Measurement of thermal distribution. A : Schematic illustration, each probe was placed 3, 6, and 9 mm laterally, and at depths of 3 and 6 mm from the laser fiber tip (dot). B : Experimental set up, 5 thermocouples probes [HYP1 (HYP0-30-1/2-T-G60-SMPW-M), Omega, Stamford, CT, USA] were located around the laser probe.

• 

  Fig. 3 The graphs of average temperature recordings. A : 3 mm laterally. B : 6 mm laterally. C : 9 mm laterally. D : 3-mm depth. E : 6-mm depth. F : All probes.

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