The Reliability of the Ultrasonic Bone Scalpel in Cervical Spondylotic Myelopathy: A Comparative Study of 46 Patients.

Abstract

In patients with cervical spondylotic myelopathy (CSM), laminectomy is usually performed with a Kerrison rongeur or a high speed drill (HSD).The HSD, which is most often selected for laminectomy, may cause complications such as duratomy, thermal and mechanical neural injuries. With an ultrasonic bone scalpel (UBS), a less traumatic laminectomy can be performed in a shorter time. The aim of this study was to compare the results of laminectomies using HSD and UBS. Evaluation was made in 46 patients who were operated on for CSM. Cervical laminectomy was performed on 23 patients using the UBS (group I) and to 23 using the HSD (group II). A comparison was made of the 2 groups in respect of demographic characteristics, laminectomy levels, mean laminectomy duration, bleeding rates, and surgical complications. In group I, the mean laminectomy time was 2.2 ± 0.4 min/level, mean blood loss was 180 mL, hospitalization was 3.0 ± 0.0 days, and C5 radiculopathy was seen in 1 patient. In group II, the mean laminectomy time was 7.4 ± 2.6 min/level, mean blood loss was 380 mL, hospitalization was 3.7 ± 1.3 days, C5 radiculopathy was seen in 1 patient and dura injuries in 3 patients. The recovery rate was determined as 47.6% in group I and 48.8% in group II. For patients with CSM, laminectomy using the UBS provides a safe, rapid, and effective decompression with a lesser blood loss. The low rate of complications lessens the postoperative morbidity rates and shortens hospital stay.