Technical advantages of an ultrasonic bone curette in spinal surgery

Restricted access

Object. The authors discuss the safety and efficacy of an ultrasonic bone curette in various spinal surgeries and report its advantages in clinical application.

Methods. Between April 2002 and September 2003, 76 patients with various spinal diseases (29 cervical, five thoracic, 40 lumbosacral, and two foramen magnum regions) were treated microsurgically by using a Sonopet ultrasonic bone curette with longitudinal and torsional tips and lightweight handpieces. The operations were performed successfully and the device was easy to handle. There were no instrument-related complications or -induced damage to any structure even when removing osseous spurs or ossified lesions near the dura mater, nerves, and vessels.

Conclusions. The ultrasonic curette is a useful instrument for procedures performed near the dura mater or other neural tissue without excessive heat production or mechanical injury. This device is recommended for various spinal surgeries in addition to high-speed drills or other tools.

Article Information

Address reprint requests to: Junichi Mizuno, M.D., Department of Neurological Surgery, Aichi Medical University, Nagakute, Aichigun, Aichi 480-1195, Japan. email: jmizuno@amugw.aichi-med-u.ac.jp.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Schematics and photographs of the Sonopet ultrasonic bone curette system. A: Two types of curettes, straight and angled, are illustrated. B: Parts of the functioning unit are illustrated while in motion, providing vibration, suction, and irrigation. C: The main monitor displays the power of ultrasonography, irrigation, and suction from left to right. D: The motions of the tip are illustrated as vibration of longitudinal tip, including vertical vibration and twisting vibration.

  • View in gallery

    Anterior approaches for cervical OPLL. Sagittal CT scans revealing cervical OPLL at C5–7 (upper left) and its absence after placement of nterbody cages at C5–6 and C6–7 (upper right). Lower: Intraoperative photograph showing that the Sonopet directly detached the OPLL (asterisk) from the PLL.

  • View in gallery

    Cervical expansive open-door laminoplasty. Preoperative (upper left) and postoperative (upper right) CT scans demonstrating a large cervical ossified PLL along the long segment and expanded spinal canal after open-door laminoplasty. Lower: Intraoperative photograph showing Sonopet-assisted removal of the inner cortex of the lamina in the right gutter during laminoplasty.

  • View in gallery

    Posterior lumbar laminectomy. Preoperative (upper left) and postoperative (upper right) CT scans demonstrating canal narrowing due to bilateral facet hypertrophy and decompression via the unilateral approach. Lower: Intraoperative photograph showing Sonopet-assisted laminectomy and superior facetectomy.

References

  • 1.

    Caillouette JTGorab RSKlapper RCAnzel SH: Revision arthroplasty facilitated by ultrasonic tool cement removal. Part I: In vitro evaluation. Orthop Rev 20:3533571991Caillouette JT Gorab RS Klapper RC Anzel SH: Revision arthroplasty facilitated by ultrasonic tool cement removal. Part I: In vitro evaluation. Orthop Rev 20:353–357 1991

    • Search Google Scholar
    • Export Citation
  • 2.

    Caillouette JTGorab RSKlapper RCAnzel SH: Revision arthroplasty facilitated by ultrasonic tool cement removal. Part II: Histologic analysis of endosteal bone after cement removal. Orthop Rev 20:4354401991Caillouette JT Gorab RS Klapper RC Anzel SH: Revision arthroplasty facilitated by ultrasonic tool cement removal. Part II: Histologic analysis of endosteal bone after cement removal. Orthop Rev 20:435–440 1991

    • Search Google Scholar
    • Export Citation
  • 3.

    Flamm ESRansohoff JWuchinich DBroadwin A: Preliminary experience with ultrasonic aspiration in neurosurgery. Neurosurgery 2:2402451978Flamm ES Ransohoff J Wuchinich D Broadwin A: Preliminary experience with ultrasonic aspiration in neurosurgery. Neurosurgery 2:240–245 1978

    • Search Google Scholar
    • Export Citation
  • 4.

    Hadeishi HSuzuki AYasui NSatou Y: Anterior clinoidectomy and opening of the internal auditory canal using an ultrasonic bone curette. Neurosurgery 52:8678712003Hadeishi H Suzuki A Yasui N Satou Y: Anterior clinoidectomy and opening of the internal auditory canal using an ultrasonic bone curette. Neurosurgery 52:867–871 2003

    • Search Google Scholar
    • Export Citation
  • 5.

    Hidaka KChiba YTakeda H: [Clinical application of ultrasonic osteome for the spinous process-splitting laminoplasty.] Spinal Surg 12:19241998 (Jpn)Hidaka K Chiba Y Takeda H: [Clinical application of ultrasonic osteome for the spinous process-splitting laminoplasty.] Spinal Surg 12:19–24 1998 (Jpn)

    • Search Google Scholar
    • Export Citation
  • 6.

    Horton JETarpley TM JrJacoway JR: Clinical applications of ultrasonic instrumentation in surgical removal of bone. Oral Surg Oral Med Oral Pathol 51:2362421981Horton JE Tarpley TM Jr Jacoway JR: Clinical applications of ultrasonic instrumentation in surgical removal of bone. Oral Surg Oral Med Oral Pathol 51:236–242 1981

    • Search Google Scholar
    • Export Citation
  • 7.

    Howard BKBeran SJKenkel JMKrueger JRohrich RJ: The effects of ultrasonic energy on peripheral nerves: implications for ultrasound-assisted liposuction. Plast Reconstr Surg 103:9849891999Howard BK Beran SJ Kenkel JM Krueger J Rohrich RJ: The effects of ultrasonic energy on peripheral nerves: implications for ultrasound-assisted liposuction. Plast Reconstr Surg 103:984–989 1999

    • Search Google Scholar
    • Export Citation
  • 8.

    Inoue HNishi HShimizu TKakizawa TKobayashi S: [Microsurgical ligamentectomy for patients with central lumbar stenosis: a unilateral approach using an ultrasonic bone scapel (Bone-Removal Bar).] Spinal Surg 17:1311382003 (Jpn)Inoue H Nishi H Shimizu T Kakizawa T Kobayashi S: [Microsurgical ligamentectomy for patients with central lumbar stenosis: a unilateral approach using an ultrasonic bone scapel (Bone-Removal Bar).] Spinal Surg 17:131–138 2003 (Jpn)

    • Search Google Scholar
    • Export Citation
  • 9.

    Inoue TIkezaki KSato Y: Ultrasononic surgical system (SONOPET) for microsurgical removal of brain tumors. Neurol Res 22:4904942000Inoue T Ikezaki K Sato Y: Ultrasononic surgical system (SONOPET) for microsurgical removal of brain tumors. Neurol Res 22:490–494 2000

    • Search Google Scholar
    • Export Citation
  • 10.

    Kelman CD: Phaco-emulsification and aspiration. A new technique of cataract removal. A preliminary report. Am J Ophthalmol 64:23351967Kelman CD: Phaco-emulsification and aspiration. A new technique of cataract removal. A preliminary report. Am J Ophthalmol 64:23–35 1967

    • Search Google Scholar
    • Export Citation
  • 11.

    Klapper RCCaillouette JTCallaghan JJHozack WJ: Ultrasonic technology in revision joint arthroplasty. Clin Orthop 285:1471541992Klapper RC Caillouette JT Callaghan JJ Hozack WJ: Ultrasonic technology in revision joint arthroplasty. Clin Orthop 285:147–154 1992

    • Search Google Scholar
    • Export Citation
  • 12.

    Nagasawa SShimano HKuroiwa T: [Ultrasonic aspirator with controllable suction system—variable action suction adaptor and clinical experience with it.] No Shinkei Geka 28:108310852000 (Jpn)Nagasawa S Shimano H Kuroiwa T: [Ultrasonic aspirator with controllable suction system—variable action suction adaptor and clinical experience with it.] No Shinkei Geka 28:1083–1085 2000 (Jpn)

    • Search Google Scholar
    • Export Citation
  • 13.

    Ridderheim PAvon Essen CZetterlund B: Indirect injury to cranial nerves after surgery with Cavitron ultrasonic surgical aspirator (CUSA). Case report. Acta Neurochir 89:84861987Ridderheim PA von Essen C Zetterlund B: Indirect injury to cranial nerves after surgery with Cavitron ultrasonic surgical aspirator (CUSA). Case report. Acta Neurochir 89:84–86 1987

    • Search Google Scholar
    • Export Citation
  • 14.

    Sawamura YFukushima TTerasaka SSugai T: Development of a handpiece and probes for a microsurgical ultrasonic aspirator: instrumentation and application. Neurosurgery 45:119211971999Sawamura Y Fukushima T Terasaka S Sugai T: Development of a handpiece and probes for a microsurgical ultrasonic aspirator: instrumentation and application. Neurosurgery 45:1192–1197 1999

    • Search Google Scholar
    • Export Citation
  • 15.

    Suetsuna FHarata SYoshimura N: Influence of the ultrasonic surgical aspirator on the dura and spinal cord. An electrohistologic study. Spine 16:5035091991Suetsuna F Harata S Yoshimura N: Influence of the ultrasonic surgical aspirator on the dura and spinal cord. An electrohistologic study. Spine 16:503–509 1991

    • Search Google Scholar
    • Export Citation
  • 16.

    Young WCohen ARHunt CDRansohoff J: Acute physiological effects of ultrasonic vibration on nervous tissue. Neurosurgery 8:6896941981Young W Cohen AR Hunt CD Ransohoff J: Acute physiological effects of ultrasonic vibration on nervous tissue. Neurosurgery 8:689–694 1981

    • Search Google Scholar
    • Export Citation

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 315 315 78
Full Text Views 79 75 1
PDF Downloads 94 82 2
EPUB Downloads 0 0 0

PubMed

Google Scholar