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

Abstract

During the last 20 years, there have been remarkable advances in the field of spine surgery. Ultrasonic bone scalpel is one of the most impactful advances. It is a unique surgical device which offers a controlled osteotomy which slices the hard bone while the soft tissues remain largely unaffected. The major benefits of using this modern instrument are the soft tissue sparing, controlled cutting, reduced bleeding, and thereby increasing the effectiveness. There are widespread studies in the literature propagating its use in various surgeries like thoracoplasties, osteotomies, vertebral column resections, laminectomies, corpectomies, laminotomy, facetectomy and scoliotic surgeries. It is one of the precise and finest instruments available for bone cutting which can be of great value while working near the vicinity of spinal cord, dura and nerve roots. Although not 100%, it can significantly minimise the risk of ripping the tissues as compared with osteotomes, Kerrison and the high-speed rotating burrs. It also has a distinct advantage of minimizing the thermal damage due to its attached irrigation component. Various studies have proven its efficiency in decreasing the operating time, increased fusion rates and decreasing the blood loss. Although it is a relatively easy technique to master on, a very basic training is required initially. So, we can safely say that ultrasonic bone scalpel is indispensable in the armamentarium of today's spine surgeon where minimally invasive surgeries are swiping in.