One-Year Evaluation of Ultrasonic Bone Scalpel Laminoplasty for Intracanal Spinal Lesions: Anatomical Reconstruction and Fusion.

Abstract

This study aims to evaluate anatomical reconstruction and bone fusion outcomes following laminoplasty using an ultrasonic bone scalpel combined with osteoplastic reconstruction via synthetic miniplates in endocanal spinal surgeries. A single-center retrospective analysis was performed on patients who underwent laminoplasty between May 2018 and May 2023 using an ultrasonic dissector and synthetic miniplates for anatomical reconstruction. Follow-up assessments included magnetic resonance imaging and subsequent computed tomography scans, with bone fusion quantified using the "Hinge Union Rate," measuring reintegration and fusion of the posterior arch at the laminar osteotomy sites at a minimum follow-up of 1 year. Twenty-four patients were included (15 females, 9 males; mean age: 49 years). Intradural tumors constituted 90% of the etiologies, predominantly neurinomas (29%), while congenital or degenerative conditions accounted for the remaining 10%. The thoracic spine was involved in 54% of cases. Mean intraoperative blood loss was 108 mL, mean surgical duration was 97 minutes, and average hospital stay was 4.5 days. At a mean follow-up of 15 months, anatomical repositioning of the posterior arch was achieved in 100% of cases, demonstrating at least one fusion point per lamina. Mean "Hinge Union" measurements were 1.95 mm (right side) and 2.01 mm (left side). No biomechanical complications or secondary deformities were observed on weight bearing imaging at the final follow-up. Laminoplasty using an ultrasonic bone scalpel with osteoplastic reconstruction via synthetic miniplates provides optimal anatomical and functional restoration of the spine. This approach minimizes surgical morbidity while ensuring wide spinal canal access.