German Team Uses Laser To Accurately Cut Bone, Dramatically Simplifying Surgical Treatment!

Recently, the "InTherSteLa" project under the Laser Center Hannover (LZH) announced that it is developing a hand-held device equipped with laser and optical monitoring functions to simplify surgical operations for spinal stenosis (narrowing of the spinal canal in the lower back).
Spinal stenosis may occur frequently in the elderly as they age, and spinal nerve compression often leads to severe pain in the body. Surgical intervention is a common treatment for such cases. Traditional surgical solutions, which typically selectively remove bone from defined areas to relieve pressure, are a major avenue through local milling procedures. However, removing the bone more precisely is a major challenge.
Laser instead of milling, increased precision with OCT
The Laser Center Hannover, Germany, and its partners are currently investigating this laser ablation-based bone removal method to see if it provides surgeons with more precise surgical control and is more comfortable for patients.
The "InTherSteLa" project, which is scheduled to run until 2025, has received 250,000 euros in federal funding, according to the report. Photonics partners involved in the project include Laseroptik and Qioptiq photonics, who will develop innovative therapies for the treatment of spinal stenosis using laser ablation under OCT control. The research project is coordinated by the Research Association for Precision Mechanics, Optics and Medical Technology (FOM) and funded by the German Federal Ministry for Economic Affairs and Climate Action (FKZ: 22642 N).
In the past, the spinal canal was usually enlarged during spinal stenosis surgery using milling tools to thin the posterior arch of the vertebrae and part of the intervertebral joints. However, this always carried the risk of injury to the underlying meninges around the neural tube and leakage of cerebrospinal fluid. These complications prolong not only the surgical procedure itself, but also the patient's recovery time.
In order to prevent these types of injuries, the researchers intend to provide surgeons with better visual control of the process by developing an instrument that allows them to see the layers of tissue beneath the bone. They can then learn with certainty how much bone can be removed without hitting the meninges with a laser built into the same platform.
Optical Coherence Tomography (OCT) helps surgeons achieve visual process control by visualizing deeper sub-bone tissue structures. Based on this, surgeons can determine how much bone can be removed without touching the meninges. ocflight, which owns the VCSEL business, said its Caliper-HERO scan source technology will be used for the OCT imaging aspect of the project.
In addition to optimizing laser parameters for bone removal and visual performance, the LZH researchers hope to drive future surgical treatments to become more practical. Endoscope-like handpieces can give surgeons the flexibility to adapt to situations during surgery. The requirements for this handheld device are being developed in collaboration with an experienced surgeon and will be subject to preclinical testing.
Handheld surgical instruments
The Laser Center in Hannover, Germany, says that bone can be precisely removed at 10-100 micrometers using lasers, making it a suitable tool for creating precise pathways to the neural tube. If necessary, milling procedures can also be combined with laser therapy.
The center has previously studied how lasers can be used in other bone surgeries, such as the LaZE project, which starts in 2020. The program investigated whether old bone cement could be removed by laser prior to hip replacement surgery, thanks to recent advances in pulse control and output power.
For the "InTherSteLa" project, the Hanover Laser Center in Germany will now study laser parameters to optimize bone removal and visual performance and consider how the platform can be put to clinical use in the future.
It ultimately envisions an endoscope-like, hand-controlled instrument that would give surgeons the flexibility to adapt to situations during surgery. The requirements for such a handheld device are being developed in collaboration with an experienced surgeon and will be tested preclinically in the future.
About Laser Center Hannover (LZH), Germany
The Laser-Zentrum Hannover (LZH) in Germany offers solutions for current, future challenges with its intelligent photonics. Along the process chain, natural scientists and engineers are able to realize interdisciplinary cooperation: from the development of components for specific laser systems or quantum technologies to the development of processes for a wide range of laser applications, such as medical and agricultural technology, or lightweight construction for the automotive industry. To date, the Laser Center Hannover, Germany has successfully spawned 19 products. The German Laser Center Hannover thus creates a strong transfer between basic science, application-oriented research and industry and uses light for innovation.