Rajitha Gunaratne G D, Khan Riaz, Fick Daniel, Robertson Brett, Dahotre Narendra, Ironside Charlie
a The Australian Institute of Robotic Orthopaedics , Perth , Australia.
b Curtin University of Technology , Perth , Australia.
J Med Eng Technol. 2017 Jan;41(1):1-12. doi: 10.1080/03091902.2016.1199743. Epub 2016 Jun 27.
Osteotomy is the surgical cutting of bone. Some obstacles to laser osteotomy have been melting, carbonisation and subsequent delayed healing. New cooled scanning techniques have resulted in effective bone cuts without the strong thermal side effects, which were observed by inappropriate irradiation techniques with continuous wave and long pulsed lasers. With these new techniques, osteotomy gaps histologically healed with new bone formation without any noticeable or minimum thermal damage. No significant cellular differences in bone healing between laser and mechanical osteotomies were noticed. Some studies even suggest that the healing rate may be enhanced following laser osteotomy compared to conventional mechanical osteotomy. Additional research is necessary to evaluate different laser types with appropriate laser setting variables to increase ablation rates, with control of depth, change in bone type and damage to adjacent soft tissue. Laser osteotomy has the potential to become incorporated into the armamentarium of bone surgery.
截骨术是对骨头进行手术切割。激光截骨术存在一些障碍,如骨熔化、碳化以及随后的愈合延迟。新的冷却扫描技术已实现有效的骨切割,且不会产生强烈的热副作用,而连续波和长脉冲激光的不适当照射技术曾观察到这种热副作用。采用这些新技术,截骨间隙在组织学上通过新骨形成实现愈合,且无明显或最小程度的热损伤。未发现激光截骨术和机械截骨术在骨愈合方面存在显著的细胞差异。一些研究甚至表明,与传统机械截骨术相比,激光截骨术后的愈合速度可能会加快。有必要开展更多研究,以评估不同类型的激光以及合适的激光设置变量,从而在控制深度、骨类型变化和对相邻软组织损伤的情况下提高消融率。激光截骨术有可能被纳入骨外科手术器械库。