Ultrasonic Bone Scalpel versus Conventional Technique for Thoracolumbar Spinal Decompression: A Prospective Randomized Controlled Trial

Abstract

Objective The purpose of the present study is to compare intraoperative blood loss, operating time, laminectomy time, hospital length of stay, and complications in thoracolumbar spinal decompression using ultrasonic bone scalpels (UBSs) with conventional procedures. Methods Forty-two patients who underwent decompressive laminectomy and pedicular screw fusion with a surgical level of 1-5 levels between February 1, 2020, and June 30, 2022, in a single institution were evaluated for eligibility, and 11 were excluded due to a history of spinal surgery ( n = 3), spinal tumor ( n = 3), and spinal infection ( n = 5). A total of 31 patients were randomly divided into the UBS group ( n =15) and the conventional group ( n =16). Intraoperative blood loss, operating time, laminectomy time, hospital length of stay, and complications were recorded. Results Intraoperative blood loss and laminectomy time were significantly lower in the UBS group (656.0 ± 167.6 ml, 54.5 ± 27.4 minutes, respectively) than in the conventional group (936.9 ± 413.2 ml, 73.4 ± 28.1 minutes, respectively). Overall operation time, hospital length of stay, and complications were all similar between the groups. Conclusion The UBS is a useful instrument for procedures performed near the dura mater or other neural tissue without excessive heat or mechanical injury. This device is recommended for various spinal surgeries in addition to high-speed burrs and Kerrison rongeurs.

Keywords: decompression, surgical; laminectomy; randomized controlled trial; thoracic vertebrae; ultrasonics.

Fig. 1

Flowchart of enrollment.

Fig. 2

(A) Illustration showing that the lamina was grasped at the spinous process and gently lifted with towel clamp forceps, and the lamina was separated. (B) Intraoperative image showing a complete decompressive laminectomy.

Fig. 1

Fluxo de matrículas.

Fig. 2 (A)

O desenho da ilustração mostra que a lâmina foi segurada no processo espinhoso e levantada suavemente com fórceps de grampo de toalha, e a lâmina foi separada. (B) A imagem intraoperatória mostra uma laminectomia descompressiva completa.