Application of Ultrasonic Bone Osteotome in Anterior Cervical Disc Resection and Fusion Surgery

Liu, Junlin; Kong, Qingquan; Peng, Feng; Chirume, Walter Munesu; Zhang, Bin; Ma, Junsong; Hu, Yuan

doi:10.1016/j.wneu.2022.03.039

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…However, during decompression, the foramen area is prone to bleeding and the visual field is blocked making the use of traditional grinding and scraping difficult. Decompression with a spoon is more difficult therefore osteophytes or ossification residues are prone to occur, and the risk of nerve damage is increased [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The spoon-shaped cutter head ensures the function of the ultrasonic bone knife similar to the electric curette, and the long handle can avoid the occlusion of the field of vision and facilitate the operation. The second is to ensure that the mid part of the spoon-shaped cutter head needs to contact the bone surface each time of curettage to avoid damage to the vertebral artery and nerve root adjacent to the intervertebral foramen area [ 14 ]. The third is to gradually expand the decompression.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of the curative effect of cervical spondylotic radiculopathy with osseous foraminal stenosis using ultrasonic osteotome in anterior cervical surgery

Liu

Kong

Peng

et al. 2023

BMC Musculoskelet Disord

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Purpose To explore the clinical efficacy and operation points of cervical radiculopathy with osseous foraminal stenosis treated with ultrasonic osteotome in anterior cervical surgery. Methods From January 2018 to June 2021，a retrospective analysis of 23 patients with cervical radiculopathy with bony foraminal stenosis during this period was retrospectively analyzed. Anterior Cervical Discectomy and Fusion (ACDF) was used for all cases in this group. Intraoperative use of ultrasonic osteotome to decompress the nerve in the intervertebral foramina. The operation time, intraoperative blood loss and complication rate were recorded in this group of patients. Interbody fusion was evaluated using Brantigan criteria. The IC-PACS imaging system was used to measure the intervertebral foramen area (IFA) before and after surgery to evaluate the range of decompression. The VAS (Visual Analogue Scale, VAS) score and NDI (Neck Disability Index, NDI) score before and after surgery were recorded to evaluate the clinical efficacy. Results All enrolled patients were followed up regularly for 1 year or more. The mean operative time was 61.5 ± 8.0 minutes. The average intraoperative blood loss was 88.3 ± 12.8 ml, and the average hospital stay was 8.1 ± 1.7d. Twenty one cases of successful fusion were followed up 1 year after operation, and the fusion rate was 91.3%. IFA expanded from 25.1 ± 4.0 mm2 before operation to 57.9 ± 3.4 mm2 at 1 year after operation, and the difference was statistically significant (P < 0.001). The VAS score and NDI score of patients 3 days after surgery, 3 months after surgery, and 1 year after surgery were significantly lower than those before surgery (P < 0.001). There was 1 case of dysphagia and 1 case of Cage subsidence after operation, and the complication rate was 8.6%. Conclusion Anterior cervical surgery using ultrasonic osteotome in the treatment of cervical radiculopathy with bony foraminal stenosis has reliable clinical efficacy and high safety, and is worthy of clinical promotion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of the curative effect of cervical spondylotic radiculopathy with osseous foraminal stenosis using ultrasonic osteotome in anterior cervical surgery

Liu

Kong

Peng

et al. 2023

BMC Musculoskelet Disord

Self Cite

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“…In terms of nerve damage. When the key hole technology under endoscope uses a grinding drill to remove the bone structure, the grinding head is likely to leak and slip, thus affecting the surrounding nerve tissue, and in serious cases, it will lead to disastrous consequences ( 29 ). This is mainly due to the poor stability of the grinding drill when the force direction of the grinding drill is toward or parallel to the spinal cord.…”

Section: Discussionmentioning

confidence: 99%

Clinical effect of channel assisted cervical key hole technology combined with ultrasonic bone osteotome in the treatment of single segment cervical spondylotic radiculopathy

et al. 2022

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ObjectiveTo explore the clinical effect and operating skills of channel assisted Cervical Key Hole technology combined with Ultrasonic Bone Osteotome (CKH-UBO) in the treatment of single segment cervical spondylotic radiculopathy (CSR).MethodsFrom June 2018 to June 2020, 14 patients diagnosed with CSR and treated with channel assisted CKH-UBO were collected. The duration of the disease, the length of the incision, the operation time, the amount of bleeding during the operation, the length of hospitalization and the complications were recorded. The Range Of Motion (ROM) and the stability of the surgical segment were recorded before and after the operation. Visual analog scale (VAS), neck disability index (NDI) and modified macnab efficacy evaluation criteria were used to evaluate the surgical efficacy.ResultsThe operative segments of the enrolled patients were all lower cervical vertebrae. The average incision length was 2.0 ± 0.1 cm, the operation time was 42.2 ± 5.7 min, the intraoperative bleeding volume was 32.7 ± 4.1 ml, and the hospital stay was 5.6 ± 1.2 days. There was no difference in ROM between preoperative and 3 months and 1 year after operation (P > 0.05), and all patients did not have segmental instability. The VAS scores of neck pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 5.6 ± 1.2, 1.6 ± 0.6, 1.1 ± 0.7, 0.6 ± 0.5, and the VAS scores of upper limb pain were 6.2 ± 1.2, 1.7 ± 0.7, 1.1 ± 0.6, 0.6 ± 0.5. The NDI scores of upper limb pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 36.7 ± 3.5, 9.8 ± 2.4, and 3.9 ± 1.5, 1.8 ± 1.0, The VAS and NDI scores at all follow-up time points after operation were significantly lower than those before operation (P < 0.001). One year after operation, the curative effect was evaluated according to the modified macnab evaluation standard, and the excellent and good rate was 100%. The complication rate was 6.25%.ConclusionChannel assisted CKH-UBO for single segment CSR has the advantages of short operation time, reliable clinical effect, high safety and low complication rate, which is worthy of clinical promotion.

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“…It is difficult for the assistant to maintain the traction force and position continuously by using the traditional S retractor during a long operation, so that the airway and esophagus and other soft tissues are repeatedly stimulated, which is easy to cause postoperative edema and increase the risk of surgery 25 . As to how to improve the operation and surgical instruments to reduce the risk of surgery has become a key point in anterior cervical surgery 26,27 . The CCRS retractor is placed by the operator according to the size and depth of the incision after fully exposing the anatomical position 28 .…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between Caspar Cervical Retractor System and Traditional S Retractor in Application on Anterior Cervical Decompression and Fixation

Wang

Qiu

Tian

et al. 2022

Orthopaedic Surgery

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Objective Although Caspar cervical retractor system (CCRS) is commonly utilized in anterior cervical decompression and fixation (ACDF), most urban hospitals still use both traditional S retractor and CCRS in conventional anterior cervical surgeries. Related data to evaluate the effect are required to be reported. The aim of this study is to compare the efficacy between using the traditional cervical S retractor and CCRS in anterior cervical decompression and fixation ACDF. Methods The retrospective study that total 360 patients received ACDF using different retractors (traditional S retractor or CCRS) were enrolled in this study from January 2010 to January 2020. Width change rate of cervical prevertebral soft tissue, throat symptoms, and subjective experiences of the operating surgeons were evaluated by t‐test or analysis of variance (ANOVA) respectively. Results The width change rate of prevertebral soft tissue was significantly higher in the S retractor group than that of the CCRS group both in single segment group (40.9% vs 20.8%, P < 0.05) and double segments group (45.8% vs 25.2%; p < 0.05). In the three segments group, the width change rate of prevertebral soft tissue was higher in the S retractor group than that of the CCRS group, but with no statistical significance (27.3% vs 23.6%; P > 0.05). The incidence rates of dysphagia, dyspnea, and throat discomfort in the traditional S retractor group were significantly higher compared to the CCRS group (P < 0.05), while satisfactory rate of surgeon was higher in the CCRS group (P < 0.05). However, there was no correlation between anterior soft tissue rate and operative time (P > 0.05), as well as the width change rate of anterior soft tissue and the DNRS score (P > 0.05). Conclusion CCRS was superior compared to the traditional S retractor in reducing the postoperative complications and the postoperative fatigue of surgeon. Meanwhile, the width change rate of prevertebral soft tissue was not related to operative time and DNRS score.

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Application of Ultrasonic Bone Osteotome in Anterior Cervical Disc Resection and Fusion Surgery

Cited by 5 publications

References 14 publications

Analysis of the curative effect of cervical spondylotic radiculopathy with osseous foraminal stenosis using ultrasonic osteotome in anterior cervical surgery

Analysis of the curative effect of cervical spondylotic radiculopathy with osseous foraminal stenosis using ultrasonic osteotome in anterior cervical surgery

Clinical effect of channel assisted cervical key hole technology combined with ultrasonic bone osteotome in the treatment of single segment cervical spondylotic radiculopathy

Comparative Study between Caspar Cervical Retractor System and Traditional S Retractor in Application on Anterior Cervical Decompression and Fixation

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