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Temperature change of epidural space by radiofrequency use in biportal endoscopic lumbar surgery: safety evaluation of radiofrequency

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Abstract

Purpose

Articles evaluating radiofrequency (RF) safety are insufficient. Thus, the purpose of this study was to investigate RF safety during biportal endoscopic lumbar decompressive laminotomy by measuring epidural temperature after RF use.

Methods

Both in vitro cadaveric study and in vivo study were performed. The epidural temperature was measured at epidural space after RF use in three cadavers. The epidural temperature was measured and analysed according to RF mode, RF power, RF usage time, and saline irrigation patency. In the in vivo study, the epidural temperature was measured after biportal endoscopic surgery. Epidural temperatures were measured around ipsilateral and contralateral traversing nerve roots after 1-s use of RF.

Results

In the in vivo study, epidural space temperature was increased by 0.31 ± 0.16 °C ipsilaterally and 0.29 ± 0.09° contralaterally after RF use in coagulation mode 1. The epidural temperature of epidural space was increased by 0.21 ± 0.13 °C ipsilaterally and 0.15 ± 0.21 °C contralaterally after RF use in high mode 2. In the in vitro study, epidural temperature was significantly increased with a long duration of RF use and a poor patency of irrigation fluid.

Conclusion

The use of RF in biportal endoscopic spine surgery might be safe. In order to reduce indirect thermal injuries caused by RF use, it might be necessary to reduce RF use time and maintain continuous saline irrigation patency well.

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Acknowledgements

Dong Hwa Heo and Don Young Park were co-first authors and equally contributed to this paper.

Funding

This research was supported by a grant of Patient-Centred Clinical Research Coordinating Centre (PACEN) funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HC20C0163).

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Authors and Affiliations

  1. Endoscopic Spine Surgery Center, Neurosurgery, Champodonamu Spine Hospital, Seoul, South Korea

    Dong Hwa Heo & Young Ho Hong

  2. Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA

    Don Yong Park

  3. Neurosurgery, Seoul Top-Spine Hospital, Seoul, South Korea

    Deahwan Kim

  4. Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Jin Sung Kim

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  1. Dong Hwa Heo
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  2. Don Yong Park
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Corresponding author

Correspondence to Jin Sung Kim.

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Conflict of interest

Dr Jin-Sung Kim is consultant in RIWOSpine, (GmbH, Germany) and Elliquence (LLC, USA).

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Heo, D.H., Park, D.Y., Hong, Y.H. et al. Temperature change of epidural space by radiofrequency use in biportal endoscopic lumbar surgery: safety evaluation of radiofrequency. Eur Spine J 32, 2769–2775 (2023). https://doi.org/10.1007/s00586-023-07719-z

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  • DOI: https://doi.org/10.1007/s00586-023-07719-z

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