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.	李玉伟, 王海蛟, 崔巍, 等. 硬脊膜松解对椎管扩大成形术治疗伴后纵韧带骨化的多节段脊髓型颈椎病疗效影响. 中国修复重建外科杂志, 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.	李玉伟, 王海蛟, 王义生, 等. 不同脊髓前方致压因素对后路手术治疗脊髓型颈椎病疗效的影响. 中国修复重建外科杂志, 2015, 29(9): 1099-1103.
6.	李玉伟, 王海蛟, 王玉记, 等. 后路单开门与一期前后路手术减压治疗前后受压脊髓型颈椎病的疗效比较. 中国脊柱脊髓杂志, 2010, 20(3): 99-102.
7.	田伟, 郎昭. 进一步促进骨磨削技术在脊柱外科的应用. 中华医学杂志, 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, 赵宇, 孙志坚. 超声骨刀在脊柱外科手术中的应用进展. 中华外科杂志, 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.	孙宇, 陈欣, 史文勇, 等. 应用超声手术刀行颈椎双开门手术的安全性与可靠性. 中国脊柱脊髓杂志, 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.	王岩, 陈仲强, 孙垂国. 超声骨刀在胸椎管狭窄症手术中应用的有效性与安全性. 中国脊柱脊髓杂志, 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. 李玉伟, 王海蛟, 崔巍, 等. 硬脊膜松解对椎管扩大成形术治疗伴后纵韧带骨化的多节段脊髓型颈椎病疗效影响. 中国修复重建外科杂志, 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. 李玉伟, 王海蛟, 王义生, 等. 不同脊髓前方致压因素对后路手术治疗脊髓型颈椎病疗效的影响. 中国修复重建外科杂志, 2015, 29(9): 1099-1103.
6. 李玉伟, 王海蛟, 王玉记, 等. 后路单开门与一期前后路手术减压治疗前后受压脊髓型颈椎病的疗效比较. 中国脊柱脊髓杂志, 2010, 20(3): 99-102.
7. 田伟, 郎昭. 进一步促进骨磨削技术在脊柱外科的应用. 中华医学杂志, 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, 赵宇, 孙志坚. 超声骨刀在脊柱外科手术中的应用进展. 中华外科杂志, 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. 孙宇, 陈欣, 史文勇, 等. 应用超声手术刀行颈椎双开门手术的安全性与可靠性. 中国脊柱脊髓杂志, 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. 王岩, 陈仲强, 孙垂国. 超声骨刀在胸椎管狭窄症手术中应用的有效性与安全性. 中国脊柱脊髓杂志, 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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