Use of Ultrasonic Device in Cervical and Thoracic Laminectomy: a Retrospective Comparative Study and Technical Note.

Multilevel severe compressive myelopathy is a challenging disorder for the surgeons, the aim of this study is to assess the efficacy and safety of a newly designed ultrasonic burr as an assistant tool to the ultrasonic scalpel in laminectomy for this disease. This is a retrospective comparative study, the included subjects were patients who received cervical and thoracic laminectomy using ultrasonic device (LUD, n = 9, 10 surgeries) and controls with the high-speed burr (LHB, n = 16). Fifteen patients (60.0%) showed severe cord occupancy and the average number of laminae operated was 3.5. Ultrasonic devices caused less blood loss (P = 0.02) and quicker operative time per level (P < 0.001) than LHB, and was associated with more operated laminae (P = 0.04). Preoperative JOA scores (P = 0.51), improvement rate (P = 0.47), and dural injury (P = 0.51) were not related to LUD. Our experience indicates ultrasonic devices are safe and effective for laminectomy treating multilevel and severe compressive myelopathy, the instrument could be used with ease especially for cases with ossified posterior longitudinal ligament and ossification of the ligamentum flavum, proper utility of the instrument is crucial to prevent complications.