Ultrasonic Osteotome Assisted Full-Endoscopic en Block Resection of Thoracic Ossified Ligamentum Flavum: Technical Note and 2 Years Follow-up

Li, Zhenzhou; Cao, Zheng; Zhao, Huanying; Shang, Wei-lin; Hou, Shuxun

doi:10.36076/ppj.2021.24.e239-e248

Cited by 4 publications

(7 citation statements)

References 38 publications

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“…In total, 23 relevant studies were included in this analysis, 10–32 enrolling 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

“…Notably, based on the current state of development of endoscopic surgical equipment and techniques, this procedure is only recommended in cases of one to two segmental TOLF, whereas open surgery or multiple staged endoscopic procedures are recommended in cases of multi-segmental TOLF. 30 , 31 Endoscopic treatment is also poorly suited to the management of nodal subtype TOLF, as these patients generally require more extensive decompression and face higher rates of dural tears. 14 …”

Section: Discussionmentioning

confidence: 99%

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Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Ye,

Guo,

et al. 2023

Spine

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Study Design. Systematic review and meta-analysis. Objective. This study systematically reviewed and evaluated the safety and efficacy of spinal endoscopic techniques as a treatment for thoracic ligamentum flavum ossification (TOLF). Summary of Background Data. The use of spinal endoscopic techniques for the treatment of TOLF has increased in recent years. The present study is the first comprehensive systematic review and meta-analysis focused on the use of spinal endoscopic techniques for TOLF. Methods. The Cochrane Central, PubMed, Web of Science, and Embase databases were systematically searched for studies focused on patients undergoing spinal endoscopic techniques to treat symptomatic TOLF. Results. This meta-analysis included 23 studies. We included 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years, with 304 total recorded lesion locations of which 245 were located in the lower thoracic spine. Complications affected 35/323 patients, and the mean operative duration for 305 patients was 108.15±47.34 minutes. For 187 patients, the mean operative bleeding was 25.13±12.54 mL, while for 87 patients the mean duration of hospitalization was 4.59±1.93 days. At last follow-up，functional assessment was performed for 260 patients, of whom 200 were in excellent condition, visual analog scale (VAS) scores were assessed for 160 patients, with a mean improvement of 4.40 (3.95,4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115 patients, with a mean improvement of 2.99 (2.77,3.22) , and modified Japanese Orthopedic Association (mJOA) scores were recorded for 208 patients, with a mean improvement of 3.41 (3.17,3.64) . Conclusions. These results support several advantages of spinal endoscopic techniques for the treatment of symptomatic TOLF. These include low complication rates, rapid postoperative recovery, and good functional recovery when used for single-segment, non-nodular ossification and no combined dural ossification.

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“…In total, 23 relevant studies were included in this analysis, 10–32 enrolling 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Ye,

Guo,

et al. 2023

Spine

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“…Ultrasonic osteotome is a new type of bone-cutting tool based on piezoelectric high-frequency mechanical vibration, which utilizes a back and forth micromotion rather than high-speed rotation to allow precise removal of bone tissue without entangling the surrounding soft tissue [ 14 ]. The energy can be preferentially transmitted to bone from the cutting edges of ultrasound osteotome.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound osteotome is the safest bone cutting tool. It has the property of selective bone-cutting without rotating, bouncing or rolling which can result in entangling the surrounding soft tissue and injury to surrounding nerve tissue [ 2 , 3 , 9 , 14 ]. It has been suggested in the literature that ultrasonic osteotome is safer and more accurate and efficient than abrasive drilling [ 2 , 3 , 9 , 14 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasonic Osteotome Assisted Posterior Endoscopic Cervical Foraminotomy in the Treatment of Cervical Spondylotic Radiculopathy Due to Osseous Foraminal Stenosis

Jiang¹,

Li²,

Yuan³

et al. 2023

J Korean Neurosurg Soc

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Objective : To investigate the efficacy and safety of the PECF using ultrasonic osteotome for the treatment of cervical osseous foraminal stenosis， focusing on introduction of the advantages of ultrasonic osteotome in partial pediculectomy and ventral osteophyte resection in PECF.Methods : Nineteen patients with cervical osseous foraminal stenosis who underwent PECF using ultrasonic osteotome in our institution between April 2018 and April 2021 were enrolled in this study. All the patients were followed up more than 12 months. The patients' medical data, as well as pre-and postoperative radiologic findings were thoroughly investigated. The visual analogue score (VAS), Japan Orthopaedic Association (JOA) score, cervical dysfunction index (NDI), and modified MacNab criteria were used to assess the surgical efficacy.Results : All the patients were successfully treated with PECF using ultrasonic osteotome. The pre-and postoperative VAS, NDI, and JOA scores were significantly improved. (P<0.05).According to the modified MacNab criteria, 17 patients were assessed as "excellent", 2 patient was assessed as "good" at the last follow up. There was no dura tear, nerve root damage, incision infection, neck deformity, or other complications. Conclusion :Adequate nerve root decompression can be accomplished successfully with the help of ultrasonic osteotome in PECF, which has the advantage of reducing the probability of damage to the nerve root and dura mater, in addition to the original merits of endoscopic surgery.

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“…On the other hand, traditional spinal surgery relies on physicians' clinical knowledge and intraoperative scanning pictures. It thus has several drawbacks, such as substantial trauma and long postoperative recovery [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Ultrasonic Osteotome on Therapeutic Efficacy and Safety of Spinal Surgery: A System Review and Meta-Analysis

Wang

2022

Computational and Mathematical Methods in Medicine

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Background. A meta-analysis was performed to evaluate the effectiveness and safety of ultrasonic osteotomes in spine surgery to standard spinal surgery procedures. Methods. Using the search keywords “bone curette”, “cutter”, “scalpel”, “bone shaver”, “aspirator”, “osteotome”, “ultrasonic”, “piezosurgery”, and “ dent ∗ ” in the databases of PubMed (1966-2021.12), Cochrane Library, Embase (1986-2018.12), Web of Science (1978-2021.12), and China Academic Journals Full-Text Database (CNKI, 1979-2021.12). Two researchers reviewed the literature, extracted and extensively assessed the data, and included information on the study quality. RevMan v5.3.5.0 was used for the meta-analysis. Results. A total of 10 trials with a total of 911 patients were included. The meta-analysis findings revealed that, when compared to traditional methods, ultrasonic osteotomes could save operation time ( OR = − 18.83 , 95 percent CI (-22.76, -14.99), P = 0.03 ) and reduce intraoperative bleeding ( OR = − 66.73 , 95 percent CI (-75.70, -57.76), P = 0.04 ) and postoperative complications ( OR = 0.38 , 95 percent CI (0.21, 0.69), P = 0.001 ). There was, however, no significant difference in the hospital stay ( OR = − 1.34 , 95 percent CI (-1.90, -0.77), P = 0.23 ) and symptom improvement rate ( OR = 1.03 , 95 percent CI (0.73, 1.45), P = 0.86 ). Conclusion. There is evidence that using an ultrasonic osteotome in spine surgery is safe and effective and may minimize intraoperative bleeding and save time. However, there is no significant difference in symptom improvement rate, hospital stay length, or postoperative complications compared to standard surgical equipment. Therefore, more high-quality investigations are needed to corroborate the initial results.

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Ultrasonic Osteotome Assisted Full-Endoscopic en Block Resection of Thoracic Ossified Ligamentum Flavum: Technical Note and 2 Years Follow-up

Cited by 4 publications

References 38 publications

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Ultrasonic Osteotome Assisted Posterior Endoscopic Cervical Foraminotomy in the Treatment of Cervical Spondylotic Radiculopathy Due to Osseous Foraminal Stenosis

Effect of Ultrasonic Osteotome on Therapeutic Efficacy and Safety of Spinal Surgery: A System Review and Meta-Analysis

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