Blood loss and operative duration using monopolar electrosurgery versus ultrasound scissors for surgical preparation during thoracoscopic ventral spondylodesis: results of a randomized, blinded, controlled trial.
OBJECTIVE
Monopolar electrosurgery is the gold standard for surgical preparation in thoracoscopic spine procedures. However, use of ultrasound scissors could decrease blood loss, accelerate the preparation time and improve patient safety, while minimizing operative costs. This trial compares both preparation techniques for ventral thoracoscopic spondylodesis.


METHODS
The study design is an open, prospective, randomized, and double-blinded two-armed clinical trial performed in two centres. Forty-one patients with vertebral body fractures from T10 to L2 were included. Primary endpoint: preparation time. Secondary endpoints: blood loss, organ injuries, duration of hospitalization.


RESULTS
Primary and secondary endpoints did not differ significantly between groups (p level 0.05). Increased blood loss (150 ml or more) was eliminated with ultrasound scissors (p = 0.0014).


CONCLUSIONS
Primary and secondary endpoints did not differ significantly between the two preparation techniques. The use of either ultrasound scissors or electric scalpel offers safe and effective preparation for thoracoscopic spine surgery.
Department of Orthopaedic and Trauma Surgery, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany, christina.otto@uk-koeln.de.
Christina
C
Otto
Gereon
G
Schiffer
Thorsten
T
Tjardes
Henning
H
Kunter
Peer
P
Eysel
Thomas
T
Paffrath
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D004311:Double-Blind Method; D004598:Electrosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013525:Surgical Instruments; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*