Article

Efficacy and safety of applying ultrasonic osteotome in cervical expansive open-door laminoplasty

  • Yan LI ,
  • Liang JIANG ,
  • Zhong-jun LIU ,
  • Xiao-guang LIU ,
  • Feng WEI ,
  • Miao YU ,
  • Li-yuan TAO
Expand
  • 1.Department of Orthopedics, 2.Research Center of Clinical Epidemicology, Peking University Third Hospital, Beijing 100191, China

Received date: 2018-08-16

  Online published: 2018-12-18

Supported by

Supported by Capital Clinical Distinctive Application Research(Z171100001017090)

Abstract

Objective: To investigate the safety and efficacy of applying ultrasonic osteotome in patients undergoning cervical expansive open-door laminoplasty (CEOL).Methods:In the study , 94 consecutive patients who were administrated in the spine group of Orthopedic Department of Peking University Third Hospital from March 2015 to March 2016 were reviewed retrospectively. All the patients were diagnosed as multilevel cervical spondylosis myelopathy and underwent CEOL. These patients were divided into two groups: ultrasonic osteotome group and traditional group, by whether the ultrasonic osteotome device was used in operation. The parameters we studied were as follows: the duration of operation, blood loss in operation, volume of drainage on the first postoperative day, days of remaining the drainage tube, preoperative and postoperative Japanese Orthopedic Association (JOA) scores, complications of cerebrospinal fluid leak and hinge bone nonunion.Results:Compared with the traditional group, the duration of operation of the ultrasonic osteotome group was increased, but the blood loss in operation, volume of drainage on the 1st postoperative day and days of remaining the drainage tube of the ultrasonic osteotome group were all reduced. There was no obvious difference between the two groups when considering the cerebrospinal fluid leak. At the end of the 3-month follow-up, the JOA score and improvement rate of the JOA score were of no obvious difference between the two groups. But the hinge bone union of the traditional group was better than the ultrasonic osteotome group. At the end of the 12-month follow-up, all the JOA score, the improvement rate of the JOA score and the hinge bone union were not obviously different between the two groups.Conclusion:Applying ultrasonic osteotome in patients undergoing cervical expansive open-door laminoplasty is both safe and effective. Compared with the rongeur, ultrasonic osteotome can cause the delayed union of the hinge bone, but it reduces the blood loss in operation, volume of postoperative drainage and days of remaining the drainage tube.

Cite this article

Yan LI , Liang JIANG , Zhong-jun LIU , Xiao-guang LIU , Feng WEI , Miao YU , Li-yuan TAO . Efficacy and safety of applying ultrasonic osteotome in cervical expansive open-door laminoplasty[J]. Journal of Peking University(Health Sciences), 2018 , 50(6) : 1092 -1097 . DOI: 10.19723/j.issn.1671-167X.2018.06.027

References

[1] Satomi K, Nishu Y, Kohno T , et al. Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy[J]. Spine, 1994,19(5):507-510.
[2] Lee TT, Green BA, Gromelski EB . Safety and stability of open-door cervical expansive laminoplasty[J]. J Spinal Disord, 1998,11(1):12-15.
[3] Satomi K, Ogawa J, Ishii Y , et al. Short-term complications and long-term results of expansive open-door laminoplasty for cervical stenotic myelopathy[J]. Spine J, 2001,1(1):26-30.
[4] Hu X, Ohnmeiss DD, Lieberman IH . Use of an ultrasonic osteotome device in spine surgery: experience from the first 128 patients[J]. Eur Spine J, 2013,22(12):2845-2849.
[5] Grauvogel J, Scheiwe C, Kaminsky J . Use of Piezosurgery for removal of retrovertebral body osteophytes in anterior cervical discectomy[J]. Spine J, 2014,14(4):628-636.
[6] 刘鑫, 王翔宇, 温冰涛 , 等. 超声骨刀在颈椎前路椎体次全切除术中应用的安全性和有效性评价[J]. 中国脊柱脊髓杂志, 2018,28(4):303-308.
[7] Rhee JM, Register B, Hamasaki T , et al. Plate-only open door laminoplasty maintains stable spinal canal expansion with high rates of hinge union and no plate failures[J]. Spine, 2011,36(1):9-14.
[8] Horton JE, Tarpley TM Jr, Jacoway JR . Clinical applications of ultrasonic instrumentation in the surgical removal of bone[J]. Oral Surg Oral Med Oral Pathol, 1981,51(3):236-242.
[9] Nakase H, Matsuda R, Shin Y , et al. The use of ultrasonic bone curettes in spinal surgery[J]. Acta Neurochir (Wien), 2006,148(2):207-212.
[10] Parker SL, Kretzer RM, Recinos PF , et al. Ultrasonic BoneScalpel for osteoplastic laminoplasty in the resection of intradural spinal pathology: case series and technical note[J]. Neurosurgery, 2013,73(1):61-66.
[11] Al-Mahfoudh R, Qattan E, Ellenbogen JR , et al. Applications of the ultrasonic bone cutter in spinal surgery: our preliminary experience[J]. Br J Neurosurg, 2014,28(1):56-60.
[12] Li K, Zhang W, Li B , et al. Safety and efficacy of cervical lami-noplasty using a Piezosurgery device compared with a high-speed drill[J]. Medicine (Baltimore), 2016,95(37):e4913.
[13] 陈颖, 罗晓宁, 史文勇 , 等. 超声手术刀的研制现状与应用[J]. 生物医学工程学杂志, 2005,22(2):377-380.
[14] Zhou Y, Gao XW . Effect of hydrodynamic cavitation in the tissue erosion by pulsed high-intensity focused ultrasound (pHIFU)[J]. Phys Med Biol, 2016,61(18):6651-6667.
[15] Chiriac G, Herten M, Schwarz F , et al. Autogenous bone chips: influence of a new piezoelectric device (Piezosurgery) on chip morphology, cell viability and differentiation[J]. J Clin Periodontol, 2005,32(9):994-999.
[16] Sirolli M, Mafra CE, Santos RA , et al. Influence of piezosurgery on bone healing around titanium implants: a histological study in rats[J]. Braz Dent J, 2016,27(3):278-283.
[17] Stelzle F, Frenkel C, Riemann M , et al. The effect of load on heat production, thermal effects and expenditure of time during implant site preparation: an experimental ex vivo comparison between piezosurgery and conventional drilling[J]. Clin Oral Implants Res, 2014,25(2):140-148.
[18] Hollstein S, Hoffmann E, Vogel J , et al. Micromorphometrical analyses of five different ultrasonic osteotomy devices at the rabbit skull[J]. Clin Oral Implants Res, 2012,23(6):713-718.
Outlines

/