Ventral sculpting decompression: a novel bone scalpel-based technique in thoracic ventral stenosis/kyphosis with myelopathy

Abstract

Background: Thoracic kyphosis is not so uncommon, which presents with devastating myelopathy. In the past, the surgical treatment for it had been somewhat controversial. Traditionally, it had been addressed by open decompression and stabilization with significant dissection and disruption of normal tissues and complications. Main body: Recently, correction techniques have evolved as the standard of care. A substantial body of evidence now supports the benefits of correction but can be questioned in view of the fact that upper dorsal kyphosis is never a cosmetic concern in our part of the world. New technique has reduced complications, but it is not solely due to the technique but due to accessory gadgets like O-arm, navigation, and IONM making it safer. We describe a method of 360°decompression alone with the use of an Ultrasonic Bone Scalpel (UBS) that preserves maximum bony stability and achieves an optimum bone sculpting that negates the need for correction. Conclusion: This technique of ventral sculpting decompression in the thoracic spine may be more utilized in the future to be applied for more wider indications.

End-points of Decompression of in Lumbar Transforaminal Endoscopic Spine Surgery: A Narrative Review of Objective and Subjective Criteria to Prevent Failures

“…This can be utilized when highly migrated fragments are there, which can be fragmented. UBS (ultrasonic bone scalpel) in COSS shows several advantages including decreased risk of mechanical injury, reduced thermal injury, and reduction in osseous bleeding, which improves visibility in the surgical field and provides significant reduction in surgical time [62][63][64][65]. Given the precision offered by UBS, and the fact that PTELD is such a selective, targeted procedure, the day when UBS will be introduced in ESS is not far away.…”