Application of piezosurgery in cervical laminectomy for cervical spondylotic myelopathy

English Keywords:Cervical spondylotic myelopathy  Laminectomy  Piezosurgery  Drill

English Abstract:

  【Abstract】 Objectives: To compare the effectiveness and reliability between piezosurgery and high-speed drill osteotomy in cervical laminectomy for cervical spondylotic myelopathy. Methods: A total of 36 patients with cervical spondylotic myelopathy who underwent posterior laminectomy surgery from January 2014 to December 2015 was retrospectively analyzed in this study. Sixteen patients(group A, M:F=9:7, age=58.4±11.7 year-old) were treated with piezosurgery osteotomy, and 20 patients(group B, M:F=11:9, age=61.6±12.4 year-old) were treated with high-speed drill osteotomy. The surgical segments, duration of surgery, intraoperative hemorrhage, postoperative drainage, pre-operative and one-week post-operative JOA(Japanses orthopedic assoiation) score, the improvement rate of JOA and perioperative complication were compared between piezosurgery group and high-speed drill group. Results: Compared with high-speed drill osteotomy, the duration of surgery and postoperative drainage of piezosurgery osteotomy group were significantly less(duration of surgery: 120.6±32.7min vs. 159.2±35.5min, postoperative drainage: 164.5±84.2ml vs. 236.2±93.4ml, P＜0.05). No significant difference was found in intraoperative hemorrhage between the two groups(141.7±76.5ml vs. 196.5±93.2ml, P＞0.05). The JOA scores were significantly improved in both groups after surgery(group A: preoperative 10.1±1.4， postoperative 14.6±1.1; group B: preoperative 10.8±2.1, postoperative 14.5±1.6; P＜0.05), but no significant difference was found in the improvement rate of JOA score [group A, (75.1±12.3)% vs. group B, (70.4±16.2)%] between the two groups(P>0.05). One case in each group experienced incidental dural tear. None of the patients had sustained cerebrospinal fluid leakage or wound infection in the both groups. Conclusions: The duration of surgery and postoperative drainage are reduced with the use of piezosurgery in cervical laminectomy for cervical spondylotic myelopathy. The effectiveness and safety of piezosurgery osteotomy is similar to the high-speed drill osteotomy.