Özgen Utku, Başak Ahmet Tulgar, Hekimoğlu Mehdi, Akçakaya Mehmet Osman, Öktenoğlu Tunç, Özer Ali Fahir, Kırış Talat
Amerikan Hastanesi, Istanbul, Turkey.
Istanbul Florence Nightingale Hospital, Istanbul, Turkey.
Int Orthop. 2025 May;49(5):1199-1210. doi: 10.1007/s00264-025-06474-8. Epub 2025 Mar 1.
In this study, we aimed to evaluate the effectiveness and safety of UBS (Ultrasonic Bone Scalpel) and HSD (High-speed drill) for performing anterior or posterior decompressions in patients with pathologies in cervical and lumbar regions.
Between October 2022 and June 2024, 60 patients underwent surgery in which a UBS (Sonopet UST-2001; Stryker Neuro Spine ENT, MI, USA) and High-speed Midas Rex MR8 (Medtronic, Fort Worth, TX, USA) drill was used. Informed consent was obtained from all patients. The study included 27 men and 33 women with a mean age of 59,5 ± 14.6 years (range: 28-85). The following patient data were recorded: preoperative and postoperative JOA scores, intraoperative blood loss, and operative time for decompression in lumbar and cervical region.
In UBS group, the mean intraoperative blood loss was 166.0 ± 64.3 ml. The mean preoperative and postoperative JOA scores were 4.5 ± 1.0 and 8.6 ± 1.8 and the mean postoperative follow-up duration was 6.1 ± 4.4 months in UBS group. The mean intraoperative blood loss was 221.2 ± 93.4 ml in HSD group. The mean preoperative and postoperative JOA scores were 5.2 ± 1.1 and 8.2 ± 1.2 in HSD group. In the HSD group, the blood loss (BL) value was significantly higher (p < 0.05) compared to the UBS group. The preoperative/postoperative JOA score improvement in the UBS group was significantly higher (p < 0.05) than in the HSD group.
The UBS can be safely used in spinal surgery. It reduces intraoperative blood loss and provide better clinical improvement. Authors would like to emphasize that the UBS resects the bone with oscillatory movements rather than rolling motions and this mechanism of action is important in reducing the risk of dura mater injury.
在本研究中，我们旨在评估超声骨刀（UBS）和高速钻（HSD）在颈椎和腰椎病变患者中进行前路或后路减压的有效性和安全性。
在2022年10月至2024年6月期间，60例患者接受了手术，术中使用了超声骨刀（Sonopet UST - 2001；美国密歇根州史赛克神经脊柱耳鼻喉科）和高速美敦力雷克斯MR8钻（美国德克萨斯州沃思堡美敦力公司）。所有患者均获得知情同意。该研究纳入了27名男性和33名女性，平均年龄为59.5±14.6岁（范围：28 - 85岁）。记录了以下患者数据：术前和术后的日本骨科协会（JOA）评分、术中失血量以及腰椎和颈椎区域减压的手术时间。
在超声骨刀组中，平均术中失血量为166.0±64.3毫升。超声骨刀组术前和术后的平均JOA评分分别为4.5±1.0和8.6±1.8，术后平均随访时间为6.1±4.4个月。高速钻组的平均术中失血量为221.2±93.4毫升。高速钻组术前和术后的平均JOA评分分别为5.2±1.1和8.2±1.2。与超声骨刀组相比，高速钻组的失血量（BL）值显著更高（p＜0.05）。超声骨刀组术前/术后JOA评分的改善显著高于高速钻组（p＜0.05）。
超声骨刀可安全用于脊柱手术。它减少了术中失血量并提供了更好的临床改善。作者想强调的是，超声骨刀通过振荡运动而不是滚动运动切除骨头，这种作用机制对于降低硬脑膜损伤风险很重要。
