Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill

Abstract

Background:Piezosurgery is a relatively new osteotomy technique using microvibrations of scalpels at ultrasonic frequencies to perform safe and effective osteotomies without damage to adjacent soft tissue, which is widely used in spinal, oral, and maxillofacial surgery. We hypothesized that such a device could also be useful in cervical laminoplasty. The purpose of this study was to compare the safety and efficacy of a piezosurgery device with those of a highspeed drill in cervical laminoplasty.Methods:A prospectively randomized clinical study was designed. Forty-two consecutive patients were enrolled in the study. All patients underwent modified expansive open-door laminoplasty and were randomly divided into 2 groups according to the instrument for transection of the lamina, using high-speed drill (drill group) or piezosurgery device (piezosurgery group). The operation time, intraoperative blood loss, and postoperative drainage were recorded. Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) as clinical assessments were quantified.Results:No significant difference was observed in the operation time between the 2 groups. In the piezosurgery group, there were less loss of the intraoperative blood and postoperative drainage compared with the drill group. However, clinical results (VAS and JOA scores) showed no significant difference between both groups during the all follow-up periods.Conclusion:The piezosurgery is a useful instrument and at least as safe and efficacious as the conventional high-speed drill in cervical laminoplasty.

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

“… 18 70,N Female, 40 Male, 30 Mean age, 61 y Follow up, N Microsurgical decompression All levels N N N N 6 Kunpeng, Li., et al . 20 42,Yes (neurological recovery comparable between 2 groups) Female, 11 Male, 31 Mean age, 57 y Follow up, N Laminectomy Cervical ≥ 3 C5 paralysis, 2(9.5) Dural laceration, 1 (4.8) d 273 e 138 f 7 Al-Mahfoudh, R., et al . 21 62,N N Laminotomy, corpectomies All levels N Dural laceration, 4 (6.5) Wound infection, 2(3.2) Neurological aggravation, 2 (3.2) C5 root lesion, 1 (1.6) N N 8 Hazer, D.B., et al .…”

“…It’s noteworthy that ultrasonic device minimizes but not totally avoids the effect on dura and cord, in previous articles describing the use of ultrasonic tools, dural tears (0.9–6.5%) and neurological aggravation (0.2–3.2%) were reported by several authors 14 , 15 , 17 , 18 , 20 – 22 . Li KP et al .…”

“…Li KP et al . 20 compared the safety and efficacy of ultrasonic device and high-speed drill in cervical laminoplasty, dural laceration occurred in 1 cases (4.8%) undergoing laminoplasty using piezosurgery device. Hu XB et al .…”

“…Ultrasonic device has been recently used as an assistant tool for osteotomy in spine surgeries 13 – 20 . Its tip vibrates at an ultrasonic frequency and selectively cut the mineralized structures such as bone, while the underlying soft tissue (e.g.…”

“…Its tip vibrates at an ultrasonic frequency and selectively cut the mineralized structures such as bone, while the underlying soft tissue (e.g. 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 .…”