Application of ultrasonic bone curette in posterior cervical single open-door laminoplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LI Yuwei , WANG Haijiao , CUI Wei , LI Cheng , ZHOU Peng , ZHANG Yonghui

Department of Spine Surgery, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P.R.China;

Corresponding?author：

LI Yuwei, Email: 460910316@qq.com

Keywords：

Cervical spondylotic myelopathy; cervical laminoplasty; ultrasonic bone curette; drill

DOI：

10.7507/1002-1892.201702002

Video：

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Objective To investigate the safety and reliability of ultrasonic bone curette in posterior cervical single open-door laminoplasty. Methods The clinical data were retrospectively analyzed, from 193 patients who underwent single open-door laminoplasty (C _3–7) from January 2012 to January 2016. The patients were divided into three groups according to different instruments: posterior single open-door laminoplasty was performed with ultrasonic bone curette in 61 cases (group A), with bite forceps in 73 cases (group B), and with micro-grinding drill in 59 cases (group C). There was no significant difference in gender, age, the course of disease, underlying disease and preoperative Japanese Orthopedic Association (JOA) score, visual analogue scale (VAS) between groups (P>0.05). The operative time, intraoperative blood loss, drainage volume at 48 hours, JOA score, improvement rate, VAS and perioperative com-plication were compared. Results The operative time, intraoperative blood loss, and drainage volume at 48 hours of group A were significantly less than those in groups B and C (P<0.05), but there was no significant between groups B and C (P>0.05). The follow-up time was 12-21 months (mean, 14.6 months) in group A, 24-36 months (mean, 27.5 months) in group B, and 28-47 months (mean, 38.1 months) in group C. There were no cerebrospinal fluid leakage and incision infection in three groups. No complications of internal fixation loosening and rupture occurred during the follow-up. Rediating pain occurred in 6 cases of group A, 8 cases of group B, and 6 cases of group C, and was cured at 1 week after dehydration and physical therapy. No nerve root palsy was found in three groups. Fracture of portal axis occurred in 5 cases (7 segments) of group B and was fixed by micro titanium plate. The JOA score and VAS score at last follow-up were significantly improved when compared with preoperative scores in three groups (P<0.05); there was no significant difference in JOA score and improvement rate and VAS score between groups (P>0.05). Conclusion It is safe and reliable to use the ultrasonic bone curette in posterior cervical single open-door laminoplasty. It can shorten the operative time and has similar clinical curative effect to the traditional operation, and the lateral rotation of the lamina can be avoided.

Citation： LI Yuwei, WANG Haijiao, CUI Wei, LI Cheng, ZHOU Peng, ZHANG Yonghui. Application of ultrasonic bone curette in posterior cervical single open-door laminoplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(6): 683-689. doi: 10.7507/1002-1892.201702002 Copy

1.	Hu W, Shen X, Sun T, et al. Laminar reclosure after single open-door laminoplasty using titanium miniplates versus suture anchors. Orthopedics, 2014, 37(1): e71-78.
2.	李玉偉, 王海蛟, 崔巍, 等. 硬脊膜松解對椎管擴大成形術治療伴后縱韌帶骨化的多節段脊髓型頸椎病療效影響. 中國修復重建外科雜志, 2016, 30(2): 178-182.
3.	Bhatia NN, Lopez G, Geck M, et al. Posterior cervical laminoplasty in the North American Population: A minimum of two year follow-up. Clin Neurol Neurosurg, 2015, 138(11): 165-168.
4.	Hardman J, Graf O, Kouloumberis PE, et al. Clinical and functional outcomes of laminoplasty and laminectomy. Neurol Res, 2010, 32(4): 416-420.
5.	李玉偉, 王海蛟, 王義生, 等. 不同脊髓前方致壓因素對后路手術治療脊髓型頸椎病療效的影響. 中國修復重建外科雜志, 2015, 29(9): 1099-1103.
6.	李玉偉, 王海蛟, 王玉記, 等. 后路單開門與一期前后路手術減壓治療前后受壓脊髓型頸椎病的療效比較. 中國脊柱脊髓雜志, 2010, 20(3): 99-102.
7.	田偉, 郎昭. 進一步促進骨磨削技術在脊柱外科的應用. 中華醫學雜志, 2015, 95(13): 961-964.
8.	Deng ZL, Chu L, Chen L, et al. Anterior transcorporeal approach of percutaneous endoscopic cervical discectomy for disc herniation at the C ₄-C ₅ levels: a technical note. Spine J, 2016, 16(5): 659-666.
9.	Chen SC, Wang MC, Wang WH, et al. Fluorescence-assisted visualization of facial nerve during mastoidectomy: A novel technique for preventing iatrogenic facial paralysis. Auris Nasus Larynx, 2015, 42(2): 113-118.
10.	李文菁, 趙宇, 孫志堅. 超聲骨刀在脊柱外科手術中的應用進展. 中華外科雜志, 2014, 52(3): 215-218.
11.	Robiony M, Gelpi F, Finotti M, et al. Maxillary Segmental Micro Osteotomy: A Human Cadaver Study on the Efficacy of the Technique. J Craniofac Surg, 2015, 26(8): 2418-2420.
12.	Kawase-Koga Y, Mori Y, Kanno Y, et al. Short Lingual Osteotomy Using a Piezosurgery Ultrasonic Bone-Cutting Device During Sagittal Split Ramus Osteotomy. J Craniofac Surg, 2015, 26(7): e567-568.
13.	Bydon M, Xu R, Papademetriou K, et al. Safety of spinal decompression using an ultrasonic bone curette compared with a high-speed drill: outcomes in 337 patients. J Neurosurg Spine, 2013, 18(6): 627-633.
14.	Ito K, Ishizaka S, Sasaki T, et al. Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: technical note. Surg Neurol, 2009, 72(5): 470-475.
15.	孫宇, 陳欣, 史文勇, 等. 應用超聲手術刀行頸椎雙開門手術的安全性與可靠性. 中國脊柱脊髓雜志, 2007, 17(6): 458-460.
16.	Sanborn MR, Balzer J, Gerszten PC, et al. Safety and efficacy of a novel ultrasonic osteotome device in an ovine model. J Clin Neurosci, 2011, 18(11): 1528-1533.
17.	王巖, 陳仲強, 孫垂國. 超聲骨刀在胸椎管狹窄癥手術中應用的有效性與安全性. 中國脊柱脊髓雜志, 2015, 25(6): 518-523.

1. Hu W, Shen X, Sun T, et al. Laminar reclosure after single open-door laminoplasty using titanium miniplates versus suture anchors. Orthopedics, 2014, 37(1): e71-78.
2. 李玉偉, 王海蛟, 崔巍, 等. 硬脊膜松解對椎管擴大成形術治療伴后縱韌帶骨化的多節段脊髓型頸椎病療效影響. 中國修復重建外科雜志, 2016, 30(2): 178-182.
3. Bhatia NN, Lopez G, Geck M, et al. Posterior cervical laminoplasty in the North American Population: A minimum of two year follow-up. Clin Neurol Neurosurg, 2015, 138(11): 165-168.
4. Hardman J, Graf O, Kouloumberis PE, et al. Clinical and functional outcomes of laminoplasty and laminectomy. Neurol Res, 2010, 32(4): 416-420.
5. 李玉偉, 王海蛟, 王義生, 等. 不同脊髓前方致壓因素對后路手術治療脊髓型頸椎病療效的影響. 中國修復重建外科雜志, 2015, 29(9): 1099-1103.
6. 李玉偉, 王海蛟, 王玉記, 等. 后路單開門與一期前后路手術減壓治療前后受壓脊髓型頸椎病的療效比較. 中國脊柱脊髓雜志, 2010, 20(3): 99-102.
7. 田偉, 郎昭. 進一步促進骨磨削技術在脊柱外科的應用. 中華醫學雜志, 2015, 95(13): 961-964.
8. Deng ZL, Chu L, Chen L, et al. Anterior transcorporeal approach of percutaneous endoscopic cervical discectomy for disc herniation at the C ₄-C ₅ levels: a technical note. Spine J, 2016, 16(5): 659-666.
9. Chen SC, Wang MC, Wang WH, et al. Fluorescence-assisted visualization of facial nerve during mastoidectomy: A novel technique for preventing iatrogenic facial paralysis. Auris Nasus Larynx, 2015, 42(2): 113-118.
10. 李文菁, 趙宇, 孫志堅. 超聲骨刀在脊柱外科手術中的應用進展. 中華外科雜志, 2014, 52(3): 215-218.
11. Robiony M, Gelpi F, Finotti M, et al. Maxillary Segmental Micro Osteotomy: A Human Cadaver Study on the Efficacy of the Technique. J Craniofac Surg, 2015, 26(8): 2418-2420.
12. Kawase-Koga Y, Mori Y, Kanno Y, et al. Short Lingual Osteotomy Using a Piezosurgery Ultrasonic Bone-Cutting Device During Sagittal Split Ramus Osteotomy. J Craniofac Surg, 2015, 26(7): e567-568.
13. Bydon M, Xu R, Papademetriou K, et al. Safety of spinal decompression using an ultrasonic bone curette compared with a high-speed drill: outcomes in 337 patients. J Neurosurg Spine, 2013, 18(6): 627-633.
14. Ito K, Ishizaka S, Sasaki T, et al. Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: technical note. Surg Neurol, 2009, 72(5): 470-475.
15. 孫宇, 陳欣, 史文勇, 等. 應用超聲手術刀行頸椎雙開門手術的安全性與可靠性. 中國脊柱脊髓雜志, 2007, 17(6): 458-460.
16. Sanborn MR, Balzer J, Gerszten PC, et al. Safety and efficacy of a novel ultrasonic osteotome device in an ovine model. J Clin Neurosci, 2011, 18(11): 1528-1533.
17. 王巖, 陳仲強, 孫垂國. 超聲骨刀在胸椎管狹窄癥手術中應用的有效性與安全性. 中國脊柱脊髓雜志, 2015, 25(6): 518-523.

Chinese Journal of Reparative and Reconstructive Surgery

Application of ultrasonic bone curette in posterior cervical single open-door laminoplasty

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