Clinical experience of cervical osteoplastic laminotomy with or without scalpel ultrasonic osteotomy with piezoelectric microvibration

Introduction : The cavitron ultrasonic surgical aspirator (CUSA®)is often used for brain tumor surgery. This tool is capable of cutting bone if the CUSA handpiece is exchanged for a scratch-type bone scalpel handpiece (SONOPEr® with scalpel handpiece, M&M Co.) with piezoelectric microvibration. Recently, ultrasonic osteotomy has been widely used in orofacial surgery. spinal surgery. and neurosurgical microsurgery. Therefore, clinical studies of ultrasonic osteotomy using the bone scalpel are required. The aim of this study was to evaluate the effectiveness of ultrasonic scalpel osteotomy by comparing postoperative outcomes. surgical complications. and long—term outcome of osteoplastic laminotomy (OL) over a 3-year period using ultrasonic scalpel osteotomy versus conventional drill surgery (low-speed drill. 8000 rpm, 3M Zimmer). Materials & Methods : We compared retrospectively the outcome between an ultrasonic scalpel osteotomy group (S) and a non-use group (N) in patients who underwent cervical 0L between 1998 and 2003 performed by a single surgeon at our hospital. The evaluated items were operation duration. blood loss, hospital stay, complications. neuroimaging findings, neurological outcome, and 3-year outcome in terms of the Kamofsky scale. Results : The amount of bleeding was significantly lower in the S group (218.3±63.7 ml vs 766.9±572.4 ml; P