Crovace Alberto Maria, Luzzi Sabino, Lacitignola Luca, Fatone Gerardo, Giotta Lucifero Alice, Vercellotti Tomaso, Crovace Antonio
Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", 70121 Bari, Italy.
Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
Vet Sci. 2020 May 22;7(2):68. doi: 10.3390/vetsci7020068.
Objective To report the physical and technical principles, clinical applications, and outcomes of the minimal invasive piezoelectric osteotomy in a consecutive veterinary neurosurgical series.
A series of 292 dogs and 32 cats underwent an osteotomy because a neurosurgical pathology performed with a Mectron Piezosurgery bone scalpel (Mectron Medical Technology, Genoa, Italy) was retrospectively reviewed. Efficacy, precision, safety, and blood loss were evaluated intraoperatively by two different surgeons, on a case-by-case basis. Postoperative Rx and CT scans were used to assess the selectivity and precision of the osteotomy. A histological study on bony specimens at the osteotomized surface was carried out to evaluate the effects of piezoelectric cutting on the osteocytes and osteoblasts. All the patients underwent a six-months follow-up. A series of illustrative cases was reported.
All the osteotomies were clear-cut and precise. A complete sparing of soft and nervous tissues and vasculature was observed. The operative field was blood- and heat-free in all cases. A range of inserts, largely different in shape and length, were allowed to treat deep and difficult-to-reach sites. Two mechanical complications occurred. Average blood loss in dogs' group was 52, 47, and 56 mL for traumatic, degenerative, and neoplastic lesions, respectively, whereas it was 25 mL for traumatized cats. A fast recovery of functions was observed in most of the treated cases, early on, at the first sixth-month evaluation. Histology on bone flaps showed the presence of live osteocytes and osteoblasts at the osteotomized surface in 92% of cases.
Piezosurgery is based on the physical principle of the indirect piezo effect. Piezoelectric osteotomy is selective, effective, and safe in bone cutting during neurosurgical veterinary procedures. It can be considered a minimal invasive technique, as it is able to spare the neighboring soft tissues and neurovascular structures.
目的 报告在连续的兽医神经外科系列中微创压电截骨术的物理和技术原理、临床应用及结果。
回顾性分析了一系列292只犬和32只猫因神经外科病理接受使用Mectron压电手术骨刀（Mectron医疗技术公司，意大利热那亚）进行截骨术的情况。由两名不同的外科医生在术中逐例评估疗效、精确性、安全性和失血量。术后通过X线和CT扫描评估截骨术的选择性和精确性。对截骨表面的骨标本进行组织学研究，以评估压电切割对骨细胞和成骨细胞的影响。所有患者均接受了6个月的随访。报告了一系列典型病例。
所有截骨术均清晰精确。观察到软组织、神经组织和脉管系统完全未受损伤。所有病例的手术视野均无血且无热损伤。一系列形状和长度差异很大的刀片可用于治疗深部和难以到达的部位。发生了2例机械并发症。犬组中，创伤性、退行性和肿瘤性病变的平均失血量分别为52、47和56 mL，而受伤猫的平均失血量为25 mL。在大多数接受治疗的病例中，在术后第6个月的首次评估时，早期就观察到功能快速恢复。骨瓣的组织学检查显示，92%的病例在截骨表面存在活的骨细胞和成骨细胞。
压电手术基于间接压电效应的物理原理。压电截骨术在兽医神经外科手术的骨切割中具有选择性、有效性和安全性。它可被视为一种微创技术，因为它能够避免损伤邻近的软组织和神经血管结构。
