The Reliability of the Ultrasonic Bone Scalpel in Cervical Spondylotic Myelopathy: A Comparative Study of 46 Patients.
BACKGROUND
In patients with cervical spondylotic myelopathy (CSM), laminectomy is usually performed with a Kerrison rongeur or a high speed drill (HSD).The HSD, which is most often selected for laminectomy, may cause complications such as duratomy, thermal and mechanical neural injuries. With an ultrasonic bone scalpel (UBS), a less traumatic laminectomy can be performed in a shorter time. The aim of this study was to compare the results of laminectomies using HSD and UBS.


METHODS
Evaluation was made in 46 patients who were operated on for CSM. Cervical laminectomy was performed on 23 patients using the UBS (group I) and to 23 using the HSD (group II). A comparison was made of the 2 groups in respect of demographic characteristics, laminectomy levels, mean laminectomy duration, bleeding rates, and surgical complications.


RESULTS
In group I, the mean laminectomy time was 2.2 ± 0.4 min/level, mean blood loss was 180 mL, hospitalization was 3.0 ± 0.0 days, and C5 radiculopathy was seen in 1 patient. In group II, the mean laminectomy time was 7.4 ± 2.6 min/level, mean blood loss was 380 mL, hospitalization was 3.7 ± 1.3 days, C5 radiculopathy was seen in 1 patient and dura injuries in 3 patients. The recovery rate was determined as 47.6% in group I and 48.8% in group II.


CONCLUSIONS
For patients with CSM, laminectomy using the UBS provides a safe, rapid, and effective decompression with a lesser blood loss. The low rate of complications lessens the postoperative morbidity rates and shortens hospital stay.
Department of Neurosurgery, Umraniye Teaching and Research, State Hospital, Istanbul, Turkey. Electronic address: mresid@gmail.com.
Mehmet Resid
MR
Onen
Department of Neurosurgery, Umraniye Teaching and Research, State Hospital, Istanbul, Turkey.
Evren
E
Yuvruk
Department of Neurosurgery, Umraniye Teaching and Research, State Hospital, Istanbul, Turkey.
Sinem
S
Akay
Department of Neurosurgery, Umraniye Teaching and Research, State Hospital, Istanbul, Turkey.
Sait
S
Naderi
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002574:Cervical Vertebrae; D019299:Decompression, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000295:instrumentation*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D015203:Reproducibility of Results; D013118:Spinal Cord Diseases / Q000601:surgery*; D055009:Spondylosis / Q000601:surgery*; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000379:methods
Cervical spondylotic myelopathy; High speed drill; Laminectomy; Ultrasound bone scalpel