Safety and Effectiveness of Modified Expansive Open-door Laminoplasty Using a Ultrasonic Bone Scalpel Compared With a High-speed Drill

Study Design: This was a retrospective study. Objective: Our study aimed to compare the effectiveness and safety of ultrasonic bone scalpel (UBS) and high-speed drill (HSD) in modified expansive open-door laminoplasty. Summary of Background Data: The traditional methods of decompression mostly use HSD and laminectomy forceps to lift the lamina. As a new type of bone cutting instrument, UBS has the advantages of good tissue selectivity, bone cutting accuracy, good hemostasis, cold cutting, and easy operation, leading to its popular use in surgery. Materials and Methods: Forty-two patients who underwent modified expansive open-door laminoplasty for multilevel cervical spondylotic myelopathy were included in this study. They were divided into HSD and UBS groups (n=18 and 24, respectively). Data on demographics, operation duration, blood loss, postoperative drainage, extubation time, length of stay, cost of hospitalization, and complications were collected and compared. Modified Japanese Orthopedic Association score, visual analog scale, Neck Disability Index, and axial symptoms were also recorded and analyzed. Results: The blood loss in the UBS group was 255.4 +/- 217.5 mL, which was lower than that in the HSD group (490.6 +/- 389.4 mL, P=0.030). The cost of hospitalization was similar between the 2 groups. The operative time and postoperative drainage did not significantly differ (P>0.05). The modified Japanese Orthopedic Association score, visual analog scale score, and Neck Disability Index score after surgery were better than those before surgery (P<0.05), but no significant difference existed between the 2 groups in each period (P>0.05). No significant difference existed in the incidence of axial symptoms and other complications (P>0.05). Conclusion: The application of the UBS to modified open-door laminoplasty resulted in a safe and effective decompression effect and reduced blood loss without increasing cost benefit.