CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(05): e706-e711
DOI: 10.1055/s-0043-1768627
Artigo Original
Coluna

Ultrasonic Bone Scalpel versus Conventional Technique for Thoracolumbar Spinal Decompression: A Prospective Randomized Controlled Trial

Article in several languages: português | English
Chok-anan Rittipoldech
1   Departamento de Ortopedia, Hatyai Hospital, Songkhla, Tailândia
,
Pawat Limsomwong
1   Departamento de Ortopedia, Hatyai Hospital, Songkhla, Tailândia
,
2   Departamento de Anatomia, Faculdade de Medicina, Chulalongkorn University, Bangkok, Tailândia
› Author Affiliations
Financial Support The authors declare that no funds, grants, or other support were received during the preparation of the present manuscript.

Abstract

Objective The purpose of the present study is to compare intraoperative blood loss, operating time, laminectomy time, hospital length of stay, and complications in thoracolumbar spinal decompression using ultrasonic bone scalpels (UBSs) with conventional procedures.

Methods Forty-two patients who underwent decompressive laminectomy and pedicular screw fusion with a surgical level of 1–5 levels between February 1, 2020, and June 30, 2022, in a single institution were evaluated for eligibility, and 11 were excluded due to a history of spinal surgery (n = 3), spinal tumor (n = 3), and spinal infection (n = 5). A total of 31 patients were randomly divided into the UBS group (n =15) and the conventional group (n =16). Intraoperative blood loss, operating time, laminectomy time, hospital length of stay, and complications were recorded.

Results Intraoperative blood loss and laminectomy time were significantly lower in the UBS group (656.0 ± 167.6 ml, 54.5 ± 27.4 minutes, respectively) than in the conventional group (936.9 ± 413.2 ml, 73.4 ± 28.1 minutes, respectively). Overall operation time, hospital length of stay, and complications were all similar between the groups.

Conclusion The UBS is a useful instrument for procedures performed near the dura mater or other neural tissue without excessive heat or mechanical injury. This device is recommended for various spinal surgeries in addition to high-speed burrs and Kerrison rongeurs.

Work developed in the Department of Orthopedics, Hatyai Hospital, Songkhla, Thailand.




Publication History

Received: 20 July 2022

Accepted: 27 September 2022

Article published online:
30 October 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • Referências

  • 1 Ravindra VM, Senglaub SS, Rattani A. et al. Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume. Global Spine J 2018; 8 (08) 784-794
  • 2 Huang YH, Ou CY. Significant Blood Loss in Lumbar Fusion Surgery for Degenerative Spine. World Neurosurg 2015; 84 (03) 780-785
  • 3 Kalff R, Ewald C, Waschke A, Gobisch L, Hopf C. Degenerative lumbar spinal stenosis in older people: current treatment options. Dtsch Arztebl Int 2013; 110 (37) 613-623 , quiz 624
  • 4 Pereira BJ, de Holanda CV, Ribeiro CA. et al. Spinal surgery for degenerative lumbar spine disease: Predictors of outcome. Clin Neurol Neurosurg 2016; 140: 1-5
  • 5 Takai K, Matsumoto T, Yabusaki H, Yokosuka J, Hatanaka R, Taniguchi M. Surgical complications associated with spinal decompression surgery in a Japanese cohort. J Clin Neurosci 2016; 26: 110-115
  • 6 Al-Mahfoudh R, Qattan E, Ellenbogen JR, Wilby M, Barrett C, Pigott T. Applications of the ultrasonic bone cutter in spinal surgery–our preliminary experience. Br J Neurosurg 2014; 28 (01) 56-60
  • 7 Dave BR, Krishnan A, Rai RR, Degulmadi D, Mayi S, Gudhe M. The Effectiveness and Safety of Ultrasonic Bone Scalpel Versus Conventional Method in Cervical Laminectomy: A Retrospective Study of 311 Patients. Global Spine J 2020; 10 (06) 760-766
  • 8 Velho V, Kharosekar H, Jasmit S, Valsangkar S, Palande DA. Ultrasonic osteotome: A cutting edge technology, our experience in 96 patients. Indian Journal of Neurosurgery 2014; 03 (03) 150-153
  • 9 Nakagawa H, Kim S-D, Mizuno J, Ohara Y, Ito K. Technical advantages of an ultrasonic bone curette in spinal surgery. J Neurosurg Spine 2005; 2 (04) 431-435
  • 10 Nakase H, Matsuda R, Shin Y, Park YS, Sakaki T. The use of ultrasonic bone curettes in spinal surgery. Acta Neurochir (Wien) 2006; 148 (02) 207-212 , discussion 212–213
  • 11 Vercellotti T. Technological characteristics and clinical indications of piezoelectric bone surgery. Minerva Stomatol 2004; 53 (05) 207-214
  • 12 Bydon M, Xu R, Papademetriou K. et al. Safety of spinal decompression using an ultrasonic bone curette compared with a high-speed drill: outcomes in 337 patients. J Neurosurg Spine 2013; 18 (06) 627-633
  • 13 Wahlquist S, Nelson S, Glivar P. Effect of the Ultrasonic Bone Scalpel on Blood Loss During Pediatric Spinal Deformity Correction Surgery. Spine Deform 2019; 7 (04) 582-587
  • 14 Lu XD, Zhao YB, Zhao XF. et al. Efficacy and Safety Analysis of Ultrasonic Bone Curette in the Treatment of Thoracic Spinal Stenosis. Orthop Surg 2019; 11 (06) 1180-1186
  • 15 Willner D, Spennati V, Stohl S, Tosti G, Aloisio S, Bilotta F. Spine Surgery and Blood Loss: Systematic Review of Clinical Evidence. Anesth Analg 2016; 123 (05) 1307-1315
  • 16 Carson JL, Poses RM, Spence RK, Bonavita G. Severity of anaemia and operative mortality and morbidity. Lancet 1988; 1 (8588): 727-729
  • 17 Proietti L, Scaramuzzo L, Schiro' GR, Sessa S, Logroscino CA. Complications in lumbar spine surgery: A retrospective analysis. Indian J Orthop 2013; 47 (04) 340-345
  • 18 Cappabianca P, Cavallo LM, Esposito I, Barakat M, Esposito F. Bone removal with a new ultrasonic bone curette during endoscopic endonasal approach to the sellar-suprasellar area: technical note. Neurosurgery 2010; 66 (suppl_1) E118