The efficacy and safety of ultrasonic bone cutter used in anterior cervical corpectomy and fusion surgery

English Keywords:Anterior cervical corpectomy  Cervical spondylotic myelopathy  Ultrasonic bone cutter

English Abstract:

  【Abstract】 Objectives: To investigate the efficacy and safety of osteotomy using ultrasonic bone cutter(UBC) in anterior cervical corpectomy and fusion surgery. Methods: A total of 51 cases diagnosed as cervical spondylotic myelopathy underwent anterior cervical corpectomy and fusion surgery from April 2015 to March 2017 in our hospital. They were divided into group A(UBC group) and group B(traditional tools group). In group A, there were 15 males and 11 females with an average age of 52.7±7.3（37-66） years old. There were 13 males and 12 females with an average age of 50.5±7.9（38-67） years old in group B. Osteotomy time, intraoperative blood loss, surgical complications such as spinal cord injury, dural tear as well as dysphagia, Japanese Orthopedic Association(JOA) score before and at 3 days after surgery, improvement rate of JOA score and hospitalization time were recorded. Results: The average osteotomy time was 8.3±1.5min in group A, which was significantly less than that in group B(11.3±1.5min, P<0.05). The average intraoperative blood loss was 122.6±28.0ml in group A, which was significantly less than that in group B(163.4±39.0ml, P<0.05). No spinal cord injury or dural tear was present in either group, and no patients had neurological deficits postoperatively. There was 1 case of dysphagia in group A, 1 case of laryngeal nerve injury and 1 case of urinary tract infection found in group B. The preoperative JOA score was 7.2±1.6 in group A and 6.8±1.4 in group B, which showed no significant difference between two groups(P>0.05). The postoperative JOA score was 11.3±1.5 and 10.9±1.3 in group A and B, respectively, which improved significantly compared with the preoperative one(P<0.05), but there were no significant differences in the improvement rate of JOA score, and hospitalization time(P>0.05). Conclusions: It is safe and effective to apply ultrasonic bone cutter in the anterior cervical corpectomy and fusion surgery. Compared with the traditional tools such as rongeur and high-speed grinding drill, the application of ultrasonic treatment can shorten the operation time and intraoperative blood loss effectively.