Artikel
Supportive use of piezosurgery in anterior cervical discectomy with fusion (ACDF)
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Autoren
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Juergen Grauvogel
- Abteilung für Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland
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Jan Kaminsky
- Abteilung für Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland
| Veröffentlicht: | 16. September 2010 |
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Gliederung
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Objective: The piezosurgical technique is based on microvibrations, which are generated by the piezoelectrical effect. Thus the piezosurgical device selectively cuts bone with preservation of adjacent soft tissue. The present study examined the applicability of Piezosurgery® as well as advantages and disadvantages of the piezosurgical device compared to the use of conventional rotating burs in patients with ACDF.
Methods: The MECTRON® piezosurgical device was used in 3 patients with cervical disc herniation and cervical spinal canal stenosis from osteophytes who underwent ACDF. After discectomy, the osteophytes were removed with Piezosurgery® to decompress the spinal canal and the foramina. An angled tip allowing bony osteophytes to cut even behind the adjacent vertebra was used. The piezosurgical device was evaluated with respect to practicability, safety, preciseness of bone cutting, and preservation of adjacent soft tissue.
Results: In all three cases the piezosurgical instrument cutted bone selectively with no damage to soft tissue, dura or neuronal tissue. No patient experienced any new neurological deficit after the operation. The handling of the instrument was very safe and the cut precise since the effect of bone drilling is caused by microvibrations instead of rotating power. All osteophytic spurs, even those behind the adjacent vertebra could be safely removed due to the angled tip of the instrument in all cases. The operation field could always clearly be visualized due to the integrated water irrigation. A disadvantage of the piezosurgical device at that time is the little inconvenient handling attributable to the short, thick handpiece which has to be used in the narrow disc space.
Conclusions: The piezosurgical device proved to be a useful and safe tool for selective bone cutting and removal of osteophytes with preservation of soft tissue and neuronal tissue in anterior cervical discectomy with fusion. In particular, the angled tip appeared to be very effective in cutting bone spurs behind the adjacent vertebra which cannot be reached with conventional rotating burs. Thus, this technique may replace corpectomies in the future.
