Comparative study of laminectomy using ultrasound bone scalpel and conventional methods

Introduction: The ultrasonic bone scalpel (UBS) is an ultrasonic device that cuts the bone without causing harm to the surrounding soft tissue and duramater. Such a type of selectivity of bone scalpel, particularly for bone destruction, makes the bone scalpel ideal for spine surgeries where there is the need to remove only bone adjacent to the duramater and neural structures, with the sparing of the duramater. Moreover, dural tear is the most common unintended complication of spinal surgeries nowadays. Materials and Methods: This is a prospective study of 100 patients operated for spinal decompression – cervical, thoracic, or lumbar – between January 2016 and June 2018 at BJ Medical College, Ahmedabad. Aim: To analyze the result of the use of UBS in spinal decompression over the conventional method of decompression, such as using the Kerrison Rongeur, high-speed burr drills, and conventional osteotome. Observation and results: Out of the 100 patients in our study, 48 patient had cervical, 14 patients had thoracic, and 38 patients had lumbar pathologies. There is significant reduction in duration of surgery and need for blood transfusion. We considered the oswestry disability index (ODI) scores to measure the clinical outcomes of using bone scalpel and conventional methods at the end of 1 year. The scores were significantly improved with both methods. We had two case of dural tear out of 54 in a patients operated with conventional mathod. No dural tear noted in 46 patient operated with UBS. No neurological worsening in any patients was present. Conclusion: The UBS is a unique surgical device that reduces heat production and decreases the chances of dural tear, which makes it a suitable instrument for different spinal surgeries in recent days.