gms | German Medical Science

Objective: The use of ultrasonic bone cutters (UBC) is known for its high security and the low risk of dura mater injuries and damage to nerve structures. But until today, the cutting speed was too low. The study was performed to investigate the clinical application of a newly developed ultrasonic bone cutter in spine surgery.

Methods: The UBC was applied in 67 cases of dorsal access with intraspinal tumour, stenosis and instability indications. The duration of surgery and the occurrence of complications were recorded. All cases were operated on by one surgeon only (first author).

Results: Intraoperatively, the UBC was easy to handle. After a short training curve, the device was used in spinal procedures including bone removal with a satisfactory time. With the UBC, the rate of dura mater injuries proved to be extremely low. Especially, in patients with lumbar stenosis the technique seems to be time saving and bony decompression is achieved comparable to other techniques, e.g. high speed drill decompression. Postoperative neurological outcome of the patients was not related to the use of the ultrasonic device. However, the limitation of the study is based on the inhomogeneous group of patients.

Conclusions: The results indicate that the UBC can be used during spine surgery with a low rate of complications. This device appears to be particularly suitable for bone removal or dissection. To prove that this is a useful addition to spinal surgical techniques, operative time, dura injuries and other device related complications compared with conventional techniques should be demonstrated in future studies.