Duerr Felix M, Seim Howard B, Bascuñán Ana L, Palmer Ross H, Easley Jeremiah
1Department of Clinical Sciences, Colorado State University Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, Colorado, USA.
J Invest Surg. 2015 Apr;28(2):103-8. doi: 10.3109/08941939.2014.981323. Epub 2014 Dec 1.
Piezoelectric surgery is a novel technology that allows for the osteotomy of mineralized tissue with less risk of damaging underlying soft tissue structures. This selective cutting increases the safety of osteotomies performed in close vicinity to delicate structures such as dura mater, blood vessels, and neural tissue. This study aimed to develop and describe the technique of piezoelectric surgery for dorsal laminectomy and to assess its clinical safety in normal sheep.
A piezoelectric, dorsal laminectomy technique was developed using ovine cadavers. Following technique development, six live sheep underwent a piezoelectric (n = 6) two-level dorsal laminectomy at L2-L3 and L4-L5 (PiezoL2-3,4-5), and another 30 live sheep underwent a three-level laminectomy at L1, L3, and L5 (PiezoL1,3,5) for a total of 102 laminectomy sites. Surgery time and postoperative complications were recorded.
Dorsal laminectomy was safely and accurately performed in 35/36 study sheep using a Piezoelectric surgical instrument. No dural tears were noted in any animal. Non-ambulatory paraparesis in one study sheep (PiezoL1,3,5) led to euthanasia at 48 hr and only mild epidural hematoma was noted on necropsy. No other major postoperative complications were observed in any of the animals. Subjectively, PiezoL was easy to perform and with a rapid learning curve. Mean surgery time was 105 min (range: 75-165 min; median: 97.5) for PiezoL2-3,4-5 and 93 minutes (range 55-100 min; median: 67.5) for PiezoL1,3,5.
Based on our study, PiezoL is considered a safe and viable technique for performing ovine dorsal laminectomy in the preclinical research setting.
压电手术是一种新型技术，可对矿化组织进行截骨，同时降低损伤深层软组织结构的风险。这种选择性切割提高了在硬脑膜、血管和神经组织等精细结构附近进行截骨术的安全性。本研究旨在开发并描述用于背部椎板切除术的压电手术技术，并评估其在正常绵羊中的临床安全性。
利用绵羊尸体开发了一种压电背部椎板切除术技术。技术开发完成后，六只活羊在L2-L3和L4-L5节段接受了压电（n = 6）两级背部椎板切除术（PiezoL2-3,4-5），另外30只活羊在L1、L3和L5节段接受了三级椎板切除术（PiezoL1,3,5），总共102个椎板切除部位。记录手术时间和术后并发症。
使用压电手术器械在35/36只研究绵羊中安全、准确地进行了背部椎板切除术。未在任何动物中发现硬脑膜撕裂。一只研究绵羊（PiezoL1,3,5）出现非行走性下肢轻瘫，在48小时时实施安乐死，尸检仅发现轻度硬膜外血肿。在任何动物中均未观察到其他重大术后并发症。主观上，PiezoL操作简便，学习曲线短。PiezoL2-3,4-5的平均手术时间为105分钟（范围：75-165分钟；中位数：97.5），PiezoL1,3,5的平均手术时间为93分钟（范围55-100分钟；中位数：67.5）。
基于我们的研究成果，在临床前研究环境中，PiezoL被认为是一种安全可行的绵羊背部椎板切除术技术。
