The use of ultrasonic bone curettes in spinal surgery.
OBJECTIVE
The author describes a clinical applications, procedure, and efficacy of ultrasonic bone curette (UBC) (bone-removal bar) in spinal surgery.


METHODS
From July 2003 to March 2005, we operated on 98 consecutive spinal disorders by using UBC, Sonopet UST-2001; Chiari type-1 malformation (6 cases), cervical disorders (64 cases), thoracic disorders (5 cases), and lumbar disorders (23 cases). The instrument was devoid of any spinning parts, and the risk of grabbing cotton pledgets and damaging normal tissue was thereby avoided. Support from assistants for irrigation and suction was not required.


RESULTS
In this series, there were no iatrogenically induced injuries for example, direct or heat damage to surrounding soft tissues, including nerves, vessels, spinal cord, and dura matter. Considering potential complications of mechanical injuries by ultrasonic technique, intermittent usage and cotton protection during use under an operating microscope are recommended. We found that the ultrasonic device is easy to handle; however, it is time consuming for removing a large amount of bone and ossified lesions. Therefore, we recommend the combined use of this method with standard drilling.


CONCLUSIONS
This system appears to be versatile, safe, and efficient in spinal surgery and could be improved by the development of a better handpiece.
Nakase
H
H
Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan. nakasehi@naramed-u.ac.jp
Matsuda
R
R
Shin
Y
Y
Park
Y-S
YS
Sakaki
T
T
D000368:Aged; D001139:Arnold-Chiari Malformation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D002114:Calcinosis / Q000503:physiopathology / Q000601:surgery; D003475:Curettage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005334:Fever / Q000517:prevention & control; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D017843:Ligamentum Flavum / Q000473:pathology / Q000601:surgery; D017846:Longitudinal Ligaments / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods