The Reliability of the Ultrasonic Bone Scalpel in Cervical Spondylotic Myelopathy: A Comparative Study of 46 Patients

Technical Aspects on the Use of Ultrasonic Bone Shaver in Spine Surgery: Experience in 307 Patients

“…The incidence of injury to the dura mater has been reported to be similar or even lower by the use of the ultrasonic bone curette when compared with air drill systems [ 3 , 4 , 18 ]. Many have reported no complications with dural tear when using ultrasonic bone curettes [ 5 , 6 , 8 , 9 ], and others have reported an incidence of dural tears between 1.6% and 9.8% [ 16 , 19 , 20 ].…”

“…In studies comparing the application of ultrasonic bone remover and high-speed drill in spinal cases, the hospital stay, the duration of the surgery, and the blood loss were found to be significantly lower with the ultrasonic bone remover [ 3 , 18 ]. In our series we have also detected low blood loss and most of our cases were completed in 90 minutes.…”

Use of Ultrasonic Device in Cervical and Thoracic Laminectomy: a Retrospective Comparative Study and Technical Note

“…A variety of surgical techniques are applicable for treating compressive myelopathy 1 – 5 , we selected posterior laminectomy with instrumented fusion in the current cases for following reasons: (1) most of patients in the present study were with severe impingement of spinal cord by multilevel lesions, in this setting, the epidural space is narrow or even missing, anterior decompression and posterior circumferential procedures predispose to iatrogenic injuries and accompany with various complications such as dural tear 13 , 16 ; (2) posterior laminectomy is technically easier and safer in comparison with direct decompression of the cord, although several authors argued that posterior decompression provides inferior neurologic recovery with an IR less than 50% 11 – 13 , surgical outcomes reported by previous literature suggested good neurologic improvement is possible after laminectomy with instrumented fusion despite residual anterior impingement of the cord 11 . (3) most OPLL responsible for symptomology in the present study were categorized as continuous type, there were no beak-type OPLL which is associated with poor outcomes after laminectomy 27 .…”

“…dura, cord, nerve roots, and vessels) is spared because it could resolve the energy by greater tissue compliance 15 , 19 , 20 . Previous articles have employed several types of device tips including the scalpel 14 , 21 , curette 17 , 18 , and microhook shaver 22 , preliminary studies certified their efficacy in various spine surgeries 14 – 16 . Nevertheless, limited articles focused on the application of ultrasonic devices in multilevel severe compressive myelopathy, which we believe is an ideal indication for this tool.…”

Alternative technique in atypical spinal decompression: the use of the ultrasonic scalpel in paediatric achondroplasia

“…Sanborn et al 13 reached a similar conclusion in ovine laminectomies, but also demonstrated neither neurophysiological nor clinical differences between groups where the ultrasonic bone scalpel was used versus traditional high speed burrs, but with improved local tissue repair and shorter operative time in the bone scalpel group. Onen et al 14 analysed 46 adult patients without achondroplasia undergoing cervical laminectomy, comparing the use of an ultrasonic bone scalpel (n=23) to a high-speed burr (n=23). They demonstrated decreased laminectomy time (2.2±0.4 vs 7.4±2.6 min/level), blood loss (180 vs 380 cc), time in hospital (3.0±0 vs 3.7±1.3 days) and complications (1 C5 radiculopathy vs 1 C5 radiculopathy and 3 dural injuries) when using the bone scalpel in preference to the high-speed burr; concluding that it was safe and effective in cervical laminectomy.…”