Comparative study between ultrasonic bone curette and traditional surgical techniques for posterior lumbar laminectomy

English Keywords:Ultrasonic bone curette  Laminectomy  Lumbar spinal stenosis

English Abstract:

  【Abstract】 Objectives: To study the effectiveness and safety of ultrasonic bone curette in lumbar laminectomy. Methods: 85 cases with lumbar canal stenosis underwent lumbar surgery in Peking University International Hospital between February 2015 and November 2016, 62 cases were performed with posterior lumbar interbody fusion(PLEF) surgery, in which 28 cases were performed by doctor c with 2-year experience in spinal surgery(group Ac), 34 cases were performed by doctor d with 25-year experience in spinal surgery(group Ad); the other 23 cases were performed with traditional instrument, in which 10 cases were performed by doctor c(group Bc), 13 cases were performed by doctor d(group Bd). All cases were diagnosed of lumbar canal stenosis, a total of 119 segments were performed, real-time laminectomy, blood loss, cases of epidural injury and nerve root injury, ODI score at 1 day preoperation and 1 week postoperation were recorded among groups. Results: The average time of laminectomy with ultrasonic curette was 3.24±0.80min(group Ac), 18.84±4.21min(group Bc), and the average operation time with traditional instrument was 3.48±0.82min(group Ad), 3.72±1.03min(group Bd). As for intraoperative blood loss, there were no significant differences of the blood loss, the ODI and VAS improvement among groups. A total of 3 cases suffered from epidural injury in this study, 2 in group A and 1 in group B， only 1 of which was related with ultrasonic curette, 1 case suffered from nerve root injury. Conclusions: Lumbar laminectomy can be safely and effectively performed by ultrasonic bone curette, which will not increase the risks of epidural injury and nerve root injury, and compared with the traditional technique, ultrasonic bone curette is easier to learn.