title: Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: technical note.
abstract: BACKGROUND
  Ultrasonic surgical aspirators have been used mainly for removing brain tumors. Because of their longitudinal and torsional tip, they are used for cutting the bone structures in spinal surgery installing a scalpel-type tip. The purpose of this report is to describe the effectiveness and surgical pitfalls of an ultrasonic bone curette in laminoplastic laminotomy and hemilaminotomy.
  
  
  METHODS
  We present 12 patients who underwent laminoplastic laminotomy and hemilaminotomy. We used a SONOPET UST-2001 ultrasonic bone curette with HB-05S handpieces (M and M Co, Ltd, Tokyo, Japan). After a tumor was removed, titanium plates were used for the laminoplastic laminotomy and hemilaminotomy. The technical advantage of an ultrasonic bone curette and procedure-related complication were examined.
  
  
  RESULTS
  There were no major procedure-related complications such as cord injury. Wound infection and subcutaneous fluid collection caused by cerebrospinal fluid leakage did not occur for reconstruction of posterior bony structure. In 1 patient with calcified dura mater associated with tumor, dural tear occurred. The width of the tip was narrow enough for resected laminae to be fused postoperatively, and spinal instability did not occur in all cases.
  
  
  CONCLUSIONS
  The scalpel-type ultrasonic bone curette is useful for cutting bone and effective for reconstruction of the laminae. Laminotomy with an ultrasonic bone curette is safe and minimally invasive. To prevent dural tear, we recommend drilling laminae to make the bone thin as the first step, followed by cutting the remaining laminae using a bone curette especially in cases with calcified or tense dura mater.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan. kitoh@shinshu-u.ac.jp
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ito
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Ishizaka
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Sasaki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Miyahara
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sakai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shigeta
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo