Instrumentation for microsurgical osseous dissection. Technical note.

The use of the operating microscope has revolutionized the surgical approach to many neurosurgical diseases. The microscope has provided magnification, binocular vision, and excellent lighting in the depths of neurosurgical wounds, allowing the performance of exceedingly delicate procedures that were previously impossible. Occasionally, an operative approach demands microscopic bone dissection. Instrumentation has been developed for working with soft tissue, but special instruments for osseous dissection have not been available. A set of newly developed punches and curettes with a bayonetted offset is described. These keep the surgeon's hand out of the operating field and allow unimpeded visualization through the operating microscope. These prototype instruments have been used successfully in over 100 microscopic neurosurgical procedures.