Journal of Clinical Orthopaedics | Vol 7 | Issue 1 | Jan-Jun 2022 | page: 20-27| TausifAhmed Shikalgar, Priyank Patel, Abhay Nene, Shubhanshu Bhaladhare, Sanjay Puri, Manojkumar Gaddiker
Author: TausifAhmed Shikalgar , Priyank Patel , Abhay Nene , Shubhanshu Bhaladhare , Sanjay Puri , Manojkumar Gaddiker 
 Department of Orthopaedics, Lilavati Hospital and Research Centre, Bandra (W), Mumbai 400050, India
Address of Correspondence
Dr. Tausif Ahmed Shikalgar,
Fellow Spine Surgery, Under Dr. Abhay Nene, Lilavati Hospital and Research Centre, Bandra (W), Mumbai – 400 050, Maharashtra, India.
The past few decades have seen tremendous improvement in the field of spine surgery. Spine surgery involves a number of procedures from simple laminectomy to deformity correction. This requires high surgical skills and care, which is achieved by a number of instruments, which, in turn, protect surgeons from committing complications. Recent advancements in spine surgery include ultrasonic bone scalpel, which cut bone accurately and precisely. It is a unique surgical device which offers a controlled osteotomy which slices the hard bone while the soft tissues remain largely unaffected. The major benefits of using this modern instrument are the soft-tissue sparing, controlled cutting, reduced bleeding, and thereby increasing the effectiveness. The aim of this article is to summarize its uses in current practice of spine surgeons and to focus on its advantages and complications associated with uses of this device.
Keywords: Ultrasonic bone scalpel, spine surgery, complications, safety, osteotomy
- Walker CT, Kakarla UK, Chang SW, Sonntag VK. History and advances in spinal neurosurgery. J Neurosurg Spine 2019;31:775-85.
- Grochulla F, Vieweg U. Surgical motor systems in spinal surgery. In: Vieweg U, Grochulla F, editors. Manual of Spine Surgery. Berlin, Heidelberg: Springer Berlin Heidelberg; 2012. p. 69-74.
- Bydon M, Macki M, Xu R, Ain MC, Ahn ES, Jallo GI. Spinal decompression in achondroplastic patients using high-speed drill versus ultrasonic bone curette: Technical note and outcomes in 30 cases. J Pediatr Orthop 2014;34:780-6.
- Nasser R, Yadla S, Maltenfort MG, Harrop JS, Anderson DG, Vaccaro AR, et al. Complications in spine surgery. J Neurosurg Spine 2010;13:14457.
- Ratliff JK, Lebude B, Albert T, Anene-Maidoh T, Anderson G, Dagostino P, et al. Complications in spinal surgery: Comparative survey of spine surgeons and patients who underwent spinal surgery. J Neurosurg Spine 2009;10:578-84.
- Nakase H, Matsuda R, Shin Y, Park YS, Sakaki T. The use of ultrasonic bone curettes in spinal surgery. Acta Neurochir 2006;148:207-12; discussion 212-3.
- Nakagawa H, Kim SD, Mizuno J, Ohara Y, Ito K. Technical advantages of an ultrasonic bone curette in spinal surgery. J Neurosurg Spine 2005;2:431-5.
- Pakzaban P. BoneScalpelTM Ultrasonic Bone Cutting System: Neurosurgical and Orthopaedic Applications, Aesculap Power Systems; 2012.
- BoneScalpel TM Ultrasonic Bone Dissector: Applications in Spine Surgery and Surgical Technique Guide.
- Moon RD, Srikandarajah N, Clark S, Wilby MJ, Pigott TD. Primary lumbar decompression using ultrasonic bone curette compared to conventional technique. Br J Neurosurg 2021;35:775-9.
- Hu X, Ohnmeiss DD, Lieberman IH. Use of an ultrasonic osteotome device in spine surgery: Experience from the first 128 patients. Eur Spine J 2013;22:2845-9.
- Hazer DB, Yaşar B, Rosberg HE, Akbaş A. Technical aspects on the use of ultrasonic bone shaver in spine surgery: Experience in 307 patients. Biomed Res Int 2016;2016:8428530.
- Bydon M, Xu R, Papademetriou K, Sciubba DM, Wolinsky JP, Witham TF, et al. Safety of spinal decompression using an ultra-sonic bone curette compared with a high-speed drill: Outcomes in 337 patients. J Neurosurg Spine 2013;18:627-33.
- Al-Mahfoudh R, Mitchell PS, Wilby M, Crooks D, Barrett C, Pillay R, et al. Management of giant calcified thoracic disks and description of the trench vertebrectomy technique. Glob Spine J 2016;6:584-91.
- Dave BR, Krishnan A, Rai RR, Degulmadi D, Mayi S, Gudhe M. The effectiveness and safety of ultrasonic bone scalpel versus conventional method in cervical laminectomy: A retrospective study of 311 patients. Glob Spine J 2020;10:760-6.
- Li K, Zhang W, Li B, Xu H, Li Z, Luo D, et al. Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill. Medicine (Baltimore) 2016;95:e4913.
- Onen MR, Yuvruk E, Akay S, Naderi S, The reliability of the ultrasonic bone scalpel in cervical spondylotic myelopathy: A comparative study of 46 patients. World Neurosurg 2015;84:1962-7.
- Al-Mahfoudh R, Qattan E, Ellenbogen JR, Wilby M, Barrett C, Pigott T. Applications of the ultrasonic bone cutter in spinal surgery our preliminary experience. Br J Neurosurg 2014;28:56-60.
- Shousha M, El-Saghir H, Boehm H. Corpectomy of the fifth lumbar vertebra, a challenging procedure. J Spinal Disord Tech 2014;27:347-51.
- Hu SS. Blood loss in adult spinal surgery. Eur Spine J 2004;13Suppl 1:S3-5.
- Dave BR, Degulmadi D, Dahibhate S, Krishnan A, Patel D. Ultrasonic bone scalpel: Utility in cervical corpectomy. A technical note. Eur Spine J 2019;28:380-5.
- Jenis LG, An HS. Spine update. Lumbar foraminal stenosis. Spine 2000;25:389-94.
- Morimoto D, Isu T, Kim K, Sugawara A, Matsumoto R, Isobe M. Microsurgical medial fenestration with an ultrasonic bone curette for lumbar foraminal stenosis. J Nippon Med Sch 2012;79:327-34.
- Chen HT, Hsu CC, Lu ML, Chen SH, Chen JM, Wu RW. Effects of combined use of ultrasonic bone scalpel and hemostatic matrix on perioperative blood loss and surgical duration in degenerative thoracolumbar spine surgery. Biomed Res Int 2019;2019:6286528.
- Hamburger C. T-laminoplasty-a surgical approach for cervicalspondylotic myelopathy. Technical note. Acta Neurochir 1995;132:131-3.
- Herman JM, Sonntag VK. Cervical corpectomy and plate fixation for postlaminectomy kyphosis. J Neurosurg 1994;80:963-70.
- Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 1983;8:693-9.
- Ito K, Ishizaka S, Sasaki T, Miyahara T, Horiuchi T, Sakai K, et al. Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: Technical note. Surg Neurol 2009;72:470-5 discussion 475.
- Park AE, Heller JG. Cervical laminoplasty: Use of a novel titanium plate to maintain canal expansion-surgical technique. J Spinal Disord Tech 2004;17:265-71.
- Matsuoka H, Itoh Y, Numazawa S, Tomii M, Watanabe K, Hirano Y, et al. Recapping hemilaminoplasty for spinal surgical disorders using ultrasonic bone curette. Surg Neurol Int 2012;3:70.
- Parker SL, Kretzer RM, Recinos PF, Molina CA, Wolinsky JP, Jallo GI, et al. Ultrasonic BoneScalpel for osteoplastic laminoplasty in the resection of intradural spinal pathology: Case series and technical note. Neurosurgery 2013;73 Suppl Operative 1:ons61-6.
- Barbanera A, Serchi E, Fiorenza V, Nina P, Andreoli A. Giant calcified thoracic herniated disc: Considerations aiming a proper surgical strategy. J Neurosurg Sci 2009;53:19-25 discussion 25-6.
- Okada Y, Shimizu K, Ido K, Kotani S. Multiple thoracic disc herniations: Case report and review of the literature. Spinal Cord 1997;35:183-6.
- Cornips EM, Janssen ML, Beuls EA. Thoracic disc herniation and acute myelopathy: Clinical presentation, neuroimaging findings, surgical considerations, and outcome. J Neurosurg. Spine 2011;14:520-8.
- Hott JS, Feiz-Erfan I, Kenny K, Dickman CA. Surgical management of giant herniated thoracic discs: Analysis of 20 cases. J eurosurg Spine 2005;3:191-7.
- Wahlquist S, Nelson S, Glivar P. Effect of the ultrasonic bone scalpel on blood loss during pediatric spinal deformity correction surgery. Spine Deform 2019;7:582-7.
- Garg S, Thomas J, Darland H, Kim E, Kittelson J, Erickson M, et al. Ultrasonic bone scalpel (USBS) does not reduce blood loss during posterior spinal fusion (PSF) in patients with adolescent idiopathic scoliosis (AIS): Randomized clinical trial. Spine (Phila Pa 1976) 2021;46:845-51.
- Kim K, Isu T, Matsumoto R, Isobe M, Kogure K. Surgical pitfalls of an ultrasonic bone curette (Sonopet) in spinal surgery. Oper Neurosurg 2006;59 Suppl 4:ONS-390; discussion ONS393.
- Brooks AT, Nelson CL, Stewart CL, Skinner RA, Siems ML. Effect of an ultrasonic device on temperatures generated in bone and on bone-cement structure. J Arthroplast 1993;8:413-8.
- Gleizal A, Bera JC, Lavandier B, Beziat JL. Piezoelectric osteotomy: A new technique for bone surgery advantages in craniofacial surgery. Childs Nerv Syst 2007;23:509-13.
|How to Cite this article: Shikalgar TA, Patel P, Nene A, Bhaladhare S, Puri S, Gaddikeri M. Ultrasonic Bone Scalpel and its Role in Spine Surgeries: An Article Review. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):20-27.|