Opt Express. 2020 Aug 17;28(17):25528-25544. doi: 10.1364/OE.396727.
Bone drilling has been widely used in medical surgeries such as repair and fixation in orthopedics. Traditional drilling method using drill-bits inevitably causes significant thermal and mechanical trauma in the adjacent bone tissues. This paper demonstrates the feasibility of femtosecond laser drilling in vitro large-size holes on the sheepshank bone with high efficiency and minimal collateral damage. A Yb:KGW femtosecond laser was utilized to drill millimeter-scale holes on the bone under different cooling conditions including gas- and water-assisted processes. Scanning electron microscopy, confocal laser scanning microscopy and infrared thermographic imaging system were used to investigate the residual debris, removal rate, bone temperature variation and hole morphology. Histological examination, Fourier transform infrared spectroscopy and Raman spectroscopy were employed to study thermal damage. Results show that a 4 mm hole with smooth and clean surface was successfully drilled on the bone, and the highest removal rate of 0.99 mm/s was achieved, which was twenty times higher than the previous study of 0.05 mm/s. Moreover, bone and bone marrow were distinguished by real-time monitoring system during laser drilling. This work demonstrates the potential for clinical applications using an ultrafast laser to produce crack-free large-size bone holes.
骨钻已广泛应用于医学手术中，如骨科修复和固定。传统的钻头钻孔方法不可避免地会对相邻的骨组织造成显著的热和机械创伤。本文展示了飞秒激光在羊胫骨上进行高效、最小化副损伤的体外大尺寸孔钻削的可行性。利用掺镱 KGW 飞秒激光器在不同冷却条件下（包括气、水辅助过程）在骨上钻毫米级孔。采用扫描电子显微镜、共聚焦激光扫描显微镜和红外热成像系统研究残余碎片、去除率、骨温度变化和孔形貌。采用组织学检查、傅里叶变换红外光谱和拉曼光谱研究热损伤。结果表明，成功地在骨上钻了一个 4mm 孔，表面光滑清洁，最高去除率为 0.99mm/s，比之前研究的 0.05mm/s 高二十倍。此外，在激光钻孔过程中，实时监测系统区分了骨和骨髓。这项工作展示了使用超快激光产生无裂纹大尺寸骨孔的临床应用潜力。
