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Research ArticleResearch Article

Preclinical Comparison of Thermal Tissue Effects from Traditional Electrosurgery and a Low-Temperature Electrosurgical Device during Anterior Cervical Discectomy and Fusion

KRIS RADCLIFF, PALANISWAMY VIJAY, RUBA F. SARRIS, MOLLY SPELTZ and JOSHUA G. VOSE
International Journal of Spine Surgery August 2018, 5059; DOI: https://doi.org/10.14444/5059
KRIS RADCLIFF
1Departments of Orthopedic Surgery and Neurological Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania
MD
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PALANISWAMY VIJAY
2Medtronic Advanced Energy LLC, Portsmouth, New Hampshire
PhD, MPH
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RUBA F. SARRIS
2Medtronic Advanced Energy LLC, Portsmouth, New Hampshire
MPH
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MOLLY SPELTZ
3Medtronic Physiologic Research Laboratories, Coon Rapids, Minnesota
DVM
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JOSHUA G. VOSE
2Medtronic Advanced Energy LLC, Portsmouth, New Hampshire
MD
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ABSTRACT

Background Exposure of the anterior cervical spine requires dissection in proximity to critical neurovascular structures. Monopolar electrosurgical (ES) devices generate heat in contacted tissues, resulting in thermal damage and temperature change. This study examined depth of thermal injury and temperature change associated with use of a low-temperature electrosurgical device (LTD) compared to traditional electrosurgery during a cadaveric anterior cervical discectomy and fusion (ACDF) dissection.

Methods ACDF was performed, using ES or LTD, on cervical spines (C3-4 and C4-5) from 2 fresh human cadavers with intact neck soft tissues and no history of surgery. Cadavers were maintained at 22–23°C, and fiber-optic temperature sensors (Neoptix, Québec City, Québec, Canada) were placed near relevant structures to measure changes during dissection. Depth of thermal injury was assessed by hematoxylin and eosin and Masson's trichrome histology of fixed tissue specimens.

Results Use of the LTD resulted in a statistically significant reduction in temperature change at platysma (3.0 ± 1.04 vs. 11.41 ± 3.10°C, P = .003), carotid sheath (7.32 ± 1.13 vs. 15.57 ± 2.56°C, P = .007), and longus colli (6.11 ± 1.32 vs. 12.9 ± 3.62°C, P = .016) compared to ES. Temperature change at the trachea was similar between groups (6.06 ± 1.99 vs. 4.96 ± 1.89°C, P = .528). Histology showed that LTD produced less mean and maximal depth of thermal injury compared to ES (mean: 0.5 vs. 1.2 mm; max: 0.9 vs. 1.8 mm; P < .05).

Conclusions The results of this pilot study demonstrate that anterior cervical spine exposure using an LTD reduces tissue temperature change and depth of thermal injury compared to ES.

Clinical Relevance Although exploratory, these results suggest that use of an LTD during ACDF may reduce the extent of thermal tissue injury during dissection. Future studies in live animal models are warranted to determine if thermal injury is a potential cause of common exposure-related complications, such as dysphagia and dysphonia.

  • anterior cervical discectomy and fusion
  • electrosurgery
  • spine surgery
  • temperature change
  • thermal injury

Footnotes

  • Disclosures and COI: K. Radcliff is a paid consultant of Medtronic but was not compensated for this study; P. Vijay, R. Sarris, M. Speltz, and J. Vose are employees of Medtronic.

  • ©International Society for the Advancement of Spine Surgery
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Preclinical Comparison of Thermal Tissue Effects from Traditional Electrosurgery and a Low-Temperature Electrosurgical Device during Anterior Cervical Discectomy and Fusion
KRIS RADCLIFF, PALANISWAMY VIJAY, RUBA F. SARRIS, MOLLY SPELTZ, JOSHUA G. VOSE
International Journal of Spine Surgery Aug 2018, 5059; DOI: 10.14444/5059

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Preclinical Comparison of Thermal Tissue Effects from Traditional Electrosurgery and a Low-Temperature Electrosurgical Device during Anterior Cervical Discectomy and Fusion
KRIS RADCLIFF, PALANISWAMY VIJAY, RUBA F. SARRIS, MOLLY SPELTZ, JOSHUA G. VOSE
International Journal of Spine Surgery Aug 2018, 5059; DOI: 10.14444/5059
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Keywords

  • anterior cervical discectomy and fusion
  • electrosurgery
  • spine surgery
  • temperature change
  • thermal injury

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