Author(s): Moon R.D.C.; Srikandarajah N.; Clark S.; Wilby M.J.; Pigott T.D.
Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 82
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Objectives: We aimed to compare ultrasonic bone curette (bone scalpel) with conventional technique (Kerrison rongeurs, upcuts and drills) for patients undergoing lumbar decompression for degenerative disease. Design: Retrospective study, utilising prospectively collected Spine Tango registry data. Subjects: Patient inclusion criteria were primary lumbar decompression for degenerative disease using bone scalpel, excluding cases involving instrumentation, fusion or discectomy. Methods: Patients between January 2014 and January 2016 were identified. These were age matched to a patient cohort who underwent lumbar laminectomy via conventional techniques. Results: 98 patients were identified within each cohort. These cohorts did not statistically differ significantly in terms of age, gender, BMI and number of vertebral levels operated on. The bone scalpel cohort had a significantly shorter operative time (p= 0.002). Dural lesions were documented in 13 bone scalpel patients (13%), as compared to 8 with conventional technique (8%). There was no significant difference in COMI between the two cohorts at either baseline (p=0.74) or after 1 year (p=0.38), and both cohorts dem-onstrated a statistically significant reduction in COMI at 1 year of follow up (bone scalpel 8.1-5.4, p=<0.0001, conventional 8.3-4.85, p< 0.0001). Conclusions: In two statistically comparable patient cohorts, ultrasonic bone curette has been shown to be equivalent to conventional technique for lumbar laminectomy in terms of outcomes, with an associated shorter operative time.