{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:45:52Z","timestamp":1784036752525,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cProgetti di Ricerca Medi 2024\u201d, Sapienza University of Rome"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>The aim of this work is to analyse the effectiveness of the medical use of the Cavitron Ultrasonic Surgical Aspirator (CUSA) in microsurgical treatment of Intramedullary Spinal Cord Tumors (IMSCTs), with a focus on the thermo-mechanical effects on neighbouring tissues to assess any potential damage. Indeed, CUSA emerges as an innovative solution, minimally invasive tumor excision technique, enabling controlled and focused operations. This study employs a Finite Element Analysis (FEA) to simulate the vibratory and thermal interactions occurring during CUSA application. A computational model of a vertebral column segment affected by an IMSCT was developed and analysed using ANSYS 2024 software. The simulations examined strain distribution, heat generation, and temperature propagation within the biological tissues. The FEA results demonstrate that the vibratory-induced strain remains highly localised to the application site, and thermal effects, though measurable, do not exceed the critical safety threshold of 46 \u00b0C established in the literature. These findings suggest that CUSA can be safely used within defined operational parameters, provided that energy settings and exposure times are carefully managed to mitigate excessive thermal accumulation. These conclusions contribute to the understanding of the thermo-mechanical interactions in ultrasonic tumour resection and aim to assist medical professionals in optimising surgical protocols.<\/jats:p>","DOI":"10.3390\/bioengineering12080842","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:25:52Z","timestamp":1754558752000},"page":"842","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ultrasonic Surgical Aspirator in Intramedullary Spinal Cord Tumours Treatment: A Simulation Study of Vibration and Temperature Field"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4249-5596","authenticated-orcid":false,"given":"Ludovica","family":"Apa","sequence":"first","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, University of Rome La Sapienza, Via Eudossiana 18, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Di Nitto","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, University of Rome La Sapienza, Via Eudossiana 18, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5131-1392","authenticated-orcid":false,"given":"Mauro","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Division of Neurosurgery, Policlinico Umberto I University Hospital, Sapienza University of Rome, 00157 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0513-2312","authenticated-orcid":false,"given":"Pietro","family":"Familiari","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Division of Neurosurgery, Policlinico Umberto I University Hospital, Sapienza University of Rome, 00157 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2314-6128","authenticated-orcid":false,"given":"Emanuele","family":"Rizzuto","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, University of Rome La Sapienza, Via Eudossiana 18, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6057-7774","authenticated-orcid":false,"given":"Zaccaria","family":"Del Prete","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, University of Rome La Sapienza, Via Eudossiana 18, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1055\/s-0035-1549029","article-title":"Intramedullary Spinal Cord Tumors: Part I\u2014Epidemiology, Pathophysiology, and Diagnosis","volume":"5","author":"Samartzis","year":"2015","journal-title":"Glob. Spine J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1023\/A:1006418506213","article-title":"Pediatric Intramedullary Spinal Cord Tumors: Special Considerations","volume":"47","author":"Houten","year":"2000","journal-title":"J. Neurooncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.3171\/2018.7.SPINE18230","article-title":"Intramedullary Spinal Cord Ependymoma and Astrocytoma: Intraoperative Frozen-Section Diagnosis, Extent of Resection, and Outcomes","volume":"30","author":"Hongo","year":"2019","journal-title":"J. Neurosurg. Spine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.crad.2013.07.017","article-title":"Differentiation between Intramedullary Spinal Ependymoma and Astrocytoma: Comparative MRI Analysis","volume":"69","author":"Kim","year":"2014","journal-title":"Clin. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.neuchi.2008.02.060","article-title":"Management of Intramedullary Spinal Cord Tumors: Surgical Considerations and Results in 45 Cases","volume":"55","author":"Berhouma","year":"2009","journal-title":"Neurochirurgie"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.3171\/2016.12.SPINE16985","article-title":"Continuous Mapping of the Corticospinal Tracts in Intramedullary Spinal Cord Tumor Surgery Using an Electrified Ultrasonic Aspirator","volume":"27","author":"Barzilai","year":"2017","journal-title":"J. Neurosurg. Spine"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pio, L., Gu\u00e9rin, F., Martucci, C., Martelli, H., Gauthier, F., and Branchereau, S. (2023). The Use of Cavitron Ultrasonic Surgical Aspirator for High-Risk Neuroblastoma with Image-Defined Risk Factors in Children. Children, 10.","DOI":"10.3390\/children10010089"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wang, Y.H., Tsai, S.C.S., and Lin, F.C.F. (2023). Reduction of Blood Loss by Means of the Cavitron Ultrasonic Surgical Aspirator for Thoracoscopic Salvage Anatomic Lung Resections. Cancers, 15.","DOI":"10.3390\/cancers15164069"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/00006123-200103000-00054","article-title":"CUSA EXcel Ultrasonic Aspiration System","volume":"48","author":"Jallo","year":"2001","journal-title":"Neurosurgery"},{"key":"ref_10","first-page":"1529","article-title":"Cusa (Cavitron Ultrasonic Surgical Aspirator) \u201cThe New Armour of Periodontal Therapy\u201d","volume":"7","author":"Sharma","year":"2022","journal-title":"Int. J. Innov. Sci. Res. Technol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"012006","DOI":"10.1088\/1742-6596\/2822\/1\/012006","article-title":"Identification of Key Performance Metrics for Different Ultrasonic Surgical Devices","volume":"2822","author":"Zhang","year":"2024","journal-title":"Proc. J. Phys. Conf. Ser. Inst. Phys."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/00007632-199105000-00003","article-title":"Influence of the Ultrasonic Surgical Aspirator on the Dura and Spinal Cord: An Electrohistologic Study","volume":"16","author":"Suetsuna","year":"1991","journal-title":"Spine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1227\/00006123-198106000-00009","article-title":"Acute Physiological Effects of Ultrasonic Vibrations on Nervous Tissue","volume":"8","author":"Young","year":"1981","journal-title":"Neurosurgery"},{"key":"ref_14","unstructured":"Davidson, C.L., Das, J.M., and Mesfin, F.B. (2025). Intramedullary Spinal Cord Tumors, StatPearls Publishing."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1080\/02688699943051","article-title":"Spinal Intradural Tumours: Part II\u2014Intramedullary","volume":"13","author":"Kane","year":"1999","journal-title":"Br. J. Neurosurg."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wu, C.Y., Yeh, W.C., Chang, S.M., Hsu, C.W., and Lin, Z.J. (2024). The Application of Deep Learning to Accurately Identify the Dimensions of Spinal Canal and Intervertebral Foramen as Evaluated by the IoU Index. Bioengineering, 11.","DOI":"10.20944\/preprints202409.0326.v1"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Wang, Z., Chen, X., Liu, B., Hai, J., Qiao, K., Yuan, Z., Yang, L., Yan, B., Su, Z., and Lu, H. (2025). Deep-Learning-Based Computer-Aided Grading of Cervical Spinal Stenosis from MR Images: Accuracy and Clinical Alignment. Bioengineering, 12.","DOI":"10.3390\/bioengineering12060604"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/02656736.2022.2028908","article-title":"Thermophysical and mechanical properties of biological tissues as a function of temperature: A systematic literature review","volume":"39","author":"Bianchi","year":"2022","journal-title":"Int. J. Hyperth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"228","DOI":"10.3109\/02656736.2014.915992","article-title":"Interstitial Ultrasound Ablation of Vertebral and Paraspinal Tumours: Parametric and Patient-Specific Simulations","volume":"30","author":"Scott","year":"2014","journal-title":"Int. J. Hyperth."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.jbiomech.2003.09.027","article-title":"Effects of Tumor Location, Shape and Surface Serration on Burst Fracture Risk in the Metastatic Spine","volume":"37","author":"Tschirhart","year":"2004","journal-title":"J. Biomech."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jmbbm.2019.01.014","article-title":"Mechanical Behavior of Metastatic Femurs through Patient-Specific Computational Models Accounting for Bone-Metastasis Interaction","volume":"93","author":"Falcinelli","year":"2019","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1111\/ner.12980","article-title":"Tissue Temperature Increases by a 10 KHz Spinal Cord Stimulation System: Phantom and Bioheat Model","volume":"24","author":"Zannou","year":"2021","journal-title":"Neuromodulation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.brs.2018.10.007","article-title":"Temperature Increases by Kilohertz Frequency Spinal Cord Stimulation","volume":"12","author":"Zannou","year":"2019","journal-title":"Brain Stimul."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1109\/TIM.2019.2904071","article-title":"Measuring the Maximum Power of an Ex Vivo Engineered Muscle Tissue with Isovelocity Shortening Technique","volume":"68","author":"Pisu","year":"2019","journal-title":"IEEE Trans. Instrum. Meas."},{"key":"ref_25","first-page":"20190364","article-title":"Biomechanical Modelling of Spinal Tumour Anisotropic Growth","volume":"476","author":"Katsamba","year":"2020","journal-title":"Proc. R. Soc. A Math. Phys. Eng. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103251","DOI":"10.1016\/j.jfluidstructs.2021.103251","article-title":"Modeling Fluid\u2013Structure Interactions between Cerebro-Spinal Fluid and the Spinal Cord","volume":"102","author":"Cardillo","year":"2021","journal-title":"J. Fluids Struct."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1002\/jbmr.5650071008","article-title":"Mechanical Properties of Trabecular Bone within and Adjacent to Osseous Metastases","volume":"7","author":"Hipp","year":"1992","journal-title":"J. Bone Miner. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"25","DOI":"10.22203\/eCM.v035a03","article-title":"The Thermal Conductivity of Cortical and Cancellous Bone","volume":"35","author":"Feldmann","year":"2018","journal-title":"Eur. Cell Mater."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/23328940.2022.2088034","article-title":"The Specific Heat of the Human Body Is Lower than Previously Believed: The Journal Temperature Toolbox","volume":"10","author":"Xu","year":"2023","journal-title":"Temperature"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.ijsolstr.2010.07.001","article-title":"A Micromechanical Model for the Young\u2019s Modulus of Adipose Tissue","volume":"47","author":"Comley","year":"2010","journal-title":"Int. J. Solids Struct."},{"key":"ref_31","unstructured":"Nedergaard, J., and Cannon, B. (2018). Brown Adipose Tissue as a Heat-Producing Thermoeffector. Handbook of Clinical Neurology, Elsevier."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jmbbm.2017.12.023","article-title":"Biomechanical Characterization of Human Dura Mater","volume":"79","author":"Vastmans","year":"2018","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1080\/03091902.2018.1435745","article-title":"Spinal Dura Mater: Biophysical Characteristics Relevant to Medical Device Development","volume":"42","author":"Nagel","year":"2018","journal-title":"J. Med. Eng. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Eslaminejad, A., Sarvghad-Moghaddam, H., Rezaei, A., Ziejewski, M., and Karami, G. (2016, January 11\u201317). Comparison of Brain Tissue Material Finite Element Models Based on Threshold for Traumatic Brain Injury. Proceedings of the ASME International Mechanical Engineering Congress and Exposition, Proceedings (IMECE), Phoenix, AZ, USA.","DOI":"10.1115\/IMECE2016-67505"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jchemneu.2017.07.004","article-title":"Mechanical Properties of the Human Spinal Cord under the Compressive Loading","volume":"86","author":"Karimi","year":"2017","journal-title":"J. Chem. Neuroanat."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Bhargav, A.G., Domino, J.S., Chamoun, R., and Thomas, S.M. (2022). Mechanical Properties in the Glioma Microenvironment: Emerging Insights and Theranostic Opportunities. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.805628"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Yacoob, S.M., and Hassan, N.S. (2012). FDTD Analysis of a Noninvasive Hyperthermia System for Brain Tumors. Biomed. Eng. Online, 11.","DOI":"10.1186\/1475-925X-11-47"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1080\/01457630801891557","article-title":"Free Convection Heat Transfer from Vertical Slender Cylinders: A Review","volume":"29","author":"Popiel","year":"2008","journal-title":"Heat Transf. Eng."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1080\/02656736.2022.2076292","article-title":"Systematic Review of the Registered Clinical Trials for Oncological Hyperthermia Treatment","volume":"39","author":"Peeters","year":"2022","journal-title":"Int. J. Hyperth."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1097\/00007632-198911000-00014","article-title":"An Experimental Study of Spinal Cord Evoked Potentials and Histologic Changes Following Spinal Cord Heating","volume":"14","author":"Uchiyama","year":"1989","journal-title":"Spine"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1097\/00007632-199211000-00020","article-title":"The Effects of Hyperthermia on the Spinal Cord","volume":"17","author":"Yamane","year":"1992","journal-title":"Spine"}],"updated-by":[{"DOI":"10.3390\/bioengineering13070805","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000}}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/8\/842\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:10:19Z","timestamp":1783998619000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/8\/842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["bioengineering12080842"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering12080842","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]}}}