A systematic literature review of ultrasonic bone curette application in spinal surgery

English Keywords:Ultrasonic bone curette  Spinal surgery  Effectiveness  Safety  Systematic review

English Abstract:

  【Abstract】 Objectives: To estimate evidence for the effectiveness and safety of ultrasonic bone curette(UBC) application in spinal surgery. Methods: A computer-based online search of Pubmed, Embase, CNKI, Wanfang and Weipu for articles published before August 1st, 2016 was performed to collect clinical articles about UBC application in spinal surgery. Two reviewers independently screened eligible articles basing on inclusion and exclusion criteria, extracted data, assessed level of evidence and recommendation grades. Results: 26 articles which encompassed 1,683 cases were finally identified for systematic review, including 2 randomized controlled trials(level Ⅱ), 6 retrospective cohort studies(level Ⅲ) and 18 case series(level　Ⅳ). Compared with traditional tools, 2 level Ⅱ and 2 level Ⅲ studies showed that UBC provided a shorter operation time, 2 level Ⅱ and 3 level Ⅲ studies showed that UBC provided a less estimated blood loss, 2 level Ⅲ studies showed that UBC provided a shorter length of hospital stay, 2 level Ⅲ and 2 level Ⅳ studies showed that UBC had a lower instrument-related complication rate, one level Ⅱ study showed that UBC had a better postoperative neurological improvement. Most studies showed that UBC provided better or similar effectiveness and safety than traditional tools, only one level Ⅲ study demonstrated an opposite result in length of hospital stay and the author interpreted it as an error. Conclusions: UBC is strongly recommended in various decompression and osteotomy procedures of spine surgery.