Effects of Combined Use of Ultrasonic Bone Scalpel and Hemostatic Matrix on Perioperative Blood Loss and Surgical Duration in Degenerative Thoracolumbar Spine Surgery

Abstract

How to decrease intraoperative bleeding, shorten surgical time, and increase safety in spinal surgery is an important issue. Ultrasonic bone removers and FloSeal have been proven to increase safety, reduce the surgical duration, and decrease intraoperative bleeding in skull base surgery. Therefore, we aimed to compare the surgical duration, blood loss, and complications during spinal surgery with or without the use of FloSeal and an ultrasonic bone scalpel. Therefore, we retrospectively reviewed 293 patients who underwent thoracolumbar spinal surgery with decompression and instrumented fusion performed by a single surgeon. We divided these patients into three groups, including nonuse of FloSeal nor a bone scalpel (group A), use of FloSeal only (group B), and use of FloSeal and a bone scalpel (group C) intraoperatively after pairing in terms of age, sex, and surgical level. The surgical duration, blood loss, and occurrence of complications were all recorded. The mean surgical duration in group A was 160 mins, in group B it was 167 mins, and in group C it was 134 mins. The mean blood loss was 700 ml in group A, 682 ml in group B, and 383 ml in group C. Six patients sustained intraoperative dura injuries in total, 3 in group A, 2 in group B, and 1 in group C. No postoperative neurologic defects or occurrences of hematoma were recorded. According to our results, we concluded that combined use of FloSeal and bone scalpels is recommended during primary thoracolumbar spinal surgery to reduce the intraoperative blood loss and shorten the surgical duration.

Ultrasonic Bone Scalpel and Its Role In Spine Surgeries : A Article Review

“…Only one patient had recurrence of radiculopathy which was associated with iatrogenic spondylosis. Post-operative Japanese Orthopaedic Association scores were improved significantly when compared with pre-operative scores, and no patient had spinal instability and malalignment [24]. As the bone cuts have to be minimal and p r e c i s e w h i l e p e r f o r m i n g a foraminotomy, the UBS seems like a goto instrument here in our practice.…”

“…There are many products in use to control bleeding such as regenerated cellulose (surgical), bipolar cautery, antifibrinolytic agents, gel foam, gelatine material (Floseal), thrombin, and fibrin glue (Tisseel). A comparative study done by Chen et al [24] showed that there is a significant difference in surgical duration and blood loss. The study showed that combined use of Floseal and UBS had led to lesser surgical duration and lesser amount of blood loss.…”

Role of Ultrasonic Bone Scalpel in Spine Surgery: a Review Article

“…Only one patient had recurrence of radiculopathy which was associated with iatrogenic spondylosis. Postoperative Japanese Orthopaedic Association scores were improved significantly when compared with preoperative scores, and no patient had spinal instability and malalignment [26].…”

“…There are many products in use to control bleeding like regenerated cellulose (surgical), bipolar cautery, antifibrinolytic agents, gel foam, gelatine material (floseal), thrombin and fibrin glue (tisseel). A comparative study done by Chen et al [26] showed that there is significant difference in surgical duration and blood. The study showed that with combined use of floseal and ultrasonic bone scalpel had led to lesser surgical duration and lesser amount of blood loss.…”

Corrigendum to “Effects of Combined Use of Ultrasonic Bone Scalpel and Hemostatic Matrix on Perioperative Blood Loss and Surgical Duration in Degenerative Thoracolumbar Spine Surgery”

“…In the article titled “Effects of Combined Use of Ultrasonic Bone Scalpel and Hemostatic Matrix on Perioperative Blood Loss and Surgical Duration in Degenerative Thoracolumbar Spine Surgery” [1], the IRB number was given incorrectly as (IRB201700086B0). The correct number should be (IRB201600834B0).…”