Ultrasonic bone curettes in spinal surgery

Abstract

Although the development of high-speed drills, in addition to an operating microscope, has greatly improved the techniques and results of spinal surgery, we are always confronted with a risk of neural or vascular injury when using drills in the spine. Ultrasonic surgical aspirators, which have been used mainly for removal of soft-tissue tumors, now can be used to cut and scrape bony structures with a longitudinal and torsional (LT) tip, which has vertical and twisted vibrations, in skull base and spinal surgeries. Recently, we introduced the ultrasonic surgical aspirator system Sonopet OST-2001 with LT tips and lightweight handpieces in 36 cases of various spinal surgeries such as anterior approaches and laminoplasty for cervical spondylosis and OPLL, and partial laminectomy for lumbar stenosis. We found that these ultrasonic bone curettes were a safe and effective alternative to the drills when working adjacent to the dura, nerves and vessels, since it did not have a risk of kicking, which could damage the nearby soft tissues. However, in order to effectively use it through a narrow and deep space under the microscope, the tips and handpieces should be further refined and adjusted for less invasive spinal surgery.