Thoracic Spine Stenosis: Does Ultrasonic Osteotome Improve Outcome in Comparison to Conventional Technique?
https://doi.org/10.5704/MOJ.2107.010
- Author:
Krishnan A
1
;
Samal P
1
;
Mayi S
1
;
Degulmadi D
1
;
Rai RR
1
;
Dave B
1
Author Information
1. Department of Spine Surgery, Stavya Spine Hospital and Research Institute, Ahmedabad, India
- Publication Type:Journal Article
- Keywords:
spinal stenosis, thoracic, decompression, osteotome, ultrasonic bone scalpel
- From:Malaysian Orthopaedic Journal
2021;15(No.2):62-69
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: To investigate the efficacy of Ultrasonic Bone
Scalpel (UBS) in thoracic spinal stenosis (TSS) in
comparison to traditional technique.
Materials and methods: A total of 55 patients who had
undergone conventional surgery (Group A) are compared
with 45 patients of UBS (Group B) in TSS. The primary
outcome measure of Modified Japanese Orthopaedic
Association score (m JOA) with neurological complications
and dural injury were assessed. Secondary outcome
measures of total blood loss (TBL), time duration of surgery
(ORT) and length of hospital stay (LHS) were analysed.
Results: The pre-operative mJOA score 5.00(4.00-6.00) in
the group A and 5.00(4.00-6.00) in the group B improved to
7.00(7.00-8.00) in the group A and 9.00(9.00-10.00) in the
group B, respectively (P<0.001) at final average follow-up of
117.55 months for group A and 75.69 months in group B.
More significant grade of myelopathy improvement and
mJOA recovery rate (RR) were noted in group B. The TBL,
ORT and LHS were more favourable in group B as compared
to group A (p<0.0001). The group A had 9 (16.36%)
neurological deficits compared to 2 (4.44%) in group B
(p<0.001). Dural tears occurred in both groups (A=11, B=9).
It was more frequent and not repairable in group A but
without significant statistical difference.
Conclusions: UBS can reduce neurological deficits and
improve outcomes in TSS. Secondarily, reduced blood loss,
lesser surgical time and reduced LHS are significant added
advantages of this new technology.
- Full text:16.2021my1176.pdf
