Comparison of ultrasonic bone curette and high-speed drill on the posterior laminectomy procedure in patients with cervical ossification of posterior longitudinal ligament

English Keywords:Ossification of posterior longitudinal ligament  Ultrasonic bone curette  Hight-speed drill  Spinal stenosis  Spinal decompression

English Abstract:

  【Abstract】 Objectives: To compare the safety and effectiveness of ultrasonic bone eurette versus high-speed drill on spinal decompression in patients with cervical ossification of posterior longitudinal ligament(OPLL). Methods: From September 2013 to December 2016, fifty-three patients who underwent posterior laminectomy decompression surgery due to cervical OPLL by either ultrasonic bone curette(group A) or high-speed drill(group B) were collected. Posterior laminectomy was performed in 24 cervical OPLL patients with 101 segments in group A, and 29 patients with 124 segments in group B. Operation time of decompressive laminectomy, blood loss, as well as perioperative complications such as durotomy, cerebrospinal fluid leak, injury of nerve root and spinal cord, Japanese Orthopaedic Association(JOA) scores and the rate of improved JOA score were recorded. Results: There was no statistical difference in age, sex ratio, preoperative JOA scores and decompressive laminectomy between the two groups(P>0.05). The average time for each segment was 1.7+1.1min(range, 1.4-3.3min) in group A, it was significantly less than that in group B[2.9±1.8min(1.9-5.6min)](P<0.05). The average blood loss for each segment was 52.4±36.5ml(35.1-285.6ml) in group A and 60.3±34.2ml（41.1-281.4ml） in group B respectively, showing no significant difference between two groups(P>0.05). The postoperative neurological function of both groups improved compared with the preoperative one(P<0.05), but there were no statistical differences of postoperative JOA scores, JOA scoring improvement rate between two groups(P>0.05). No patient suffered from injury of nerve root and spinal cord or dural matter tearing during operation and no patients had neurological deficits postoperatively. Conclusions: Compared with high-speed drill, usage of ultrasonic bone curette is more efficient but similarly safe to perform posterior laminectomy for cervical OPLL patients.