Application of Oscillating Saw for Lumbar en Bloc Laminectomy: A Case Series | ||
| The Archives of Bone and Joint Surgery | ||
| دوره 8، شماره 3، مرداد 2020، صفحه 407-412 اصل مقاله (1.48 M) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2020.15759 | ||
| نویسندگان | ||
| Farshad Nikouei1؛ Naveed Nabizadeh2؛ Elham Mirzamohammadi3؛ Maryam Ameri4؛ Saeed Sabbaghan2؛ Behrooz Givehchian* 2؛ Farshad Safdari5 | ||
| 1Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran 2 Faculty of Medicine, | ||
| 2Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran | ||
| 3Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran | ||
| 4Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran | ||
| 5Bone and Joint Related Tissue Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran | ||
| چکیده | ||
| Background: An oscillating bone saw is rarely used to perform laminectomy. The purpose of this study was to describe a relatively quick and harmless technique for multilevel laminectomy in patients with lumbar spinal stenosis (LSS) using an oscillating bone saw to find out how this instrument affects the time of surgery and rate of complications. Methods: This prospective study was conducted on 45 patients with LSS who required multilevel laminectomy. The bones were cut using an oscillating sagittal saw equipped with a fine 1-cm blade. Posterolateral fusion was performed if any evidence of spinal instability occurred, or the correction of deformity was addressed. The time spent for laminectomy from initial cutting to the whole bone removal (T1) and the duration of laminectomy (i.e., from initiation to the end of decompression; T2) were recorded for the corresponding level. The volume of harvested autograft was also measured, and any dural injuries were reported. Results: Posterolateral fusion was performed on 32 (71.1%) patients. The mean T1 and T2 per level were estimated at 70.5±5.4 and 157.5±12.1 sec, respectively. In addition, the mean volume of harvested autograft per level was obtained as 3.5±1.2 cc. No durotomy was observed during laminectomy using an oscillating bone saw. However, a dural tear occurred in one patient when a Kerisson punch was utilized for ligamentum flavum removal and foraminotomy. Conclusion: Based on the findings, it can be concluded that laminectomy by means of the oscillating bone saw is a safe procedure that provides a sufficient volume of harvested autograft for fusion. This technique could also induce a remarkable reduction in the time of surgery. Level of evidence: IV | ||
| کلیدواژهها | ||
| Decompression؛ Laminectomy؛ Lumbar spine؛ Oscillating saw؛ Stenosis | ||
| مراجع | ||
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1. Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA. 2010; 303(13):1259-65. 2. Kalichman L, Cole R, Kim DH, Li L, Suri P, Guermazi A, et al. Spinal stenosis prevalence and association with symptoms: the framingham study. Spine J. 2009; 9(7):545-50. 3. Bresnahan L, Ogden AT, Natarajan RN, Fessler RG. A biomechanical evaluation of graded posterior element removal for treatment of lumbar stenosis: comparison of a minimally invasive approach with two standard laminectomy techniques. Spine. 2009; 34(1):17-23. 4. Overdevest G, Vleggeert-Lankamp C, Jacobs W, Thomé C, Gunzburg R, Peul W. Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis. Eur Spine J. 2015; 24(10):2244-63. 5. Postacchini F. Surgical management of lumbar spinal stenosis. Spine. 1999; 24(10):1043-7. 6. Gunzburg R, Szpalski M. The conservative surgical treatment of lumbar spinal stenosis in the elderly. Eur Spine J. 2003;12(Suppl 2):S176-80. 7. Ramani PS, Shoda M, Zileli M, Dohrmann GJ. Surgical management of cervical disc herniation. New Delhi, India: Jaypee Brothers Publishers; 2013. 8. Ray CD. New techniques for decompression of lumbar spinal stenosis. Neurosurgery. 1982; 10(5):587-92. 9. Djurasovic M, Glassman SD, Carreon LY, Dimar JR. Contemporary management of symptomatic lumbar spinal stenosis. Orthop Clin North Am. 2010; 41(2):183-91. 10. Guerin P, El Fegoun AB, Obeid I, Gille O, Lelong L, Luc S, et al. Incidental durotomy during spine surgery: incidence, management and complications. A retrospective review. Injury. 2012; 43(4):397-401. 11. Turner JA, Ersek M, Herron L, Deyo R. Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature. Spine (Phila Pa 1976). 1992; 17(1):1-8. 12. Kalevski SK, Peev NA, Haritonov DG. Incidental Dural Tears in lumbar decompressive surgery: incidence, causes, treatment, results. Asian J Neurosurg. 2010; 5(1):54-9. 13. Papavero L, Engler N, Kothe R. Incidental durotomy in spine surgery: first aid in ten steps. Eur Spine J. 2015; 24(9):2077-84. 14. 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(12):2845-9. 15. Rama B, Markakis E, Kolenda H, Jansen J. Reconstruction instead of resection: laminotomy and laminoplasty. Neurochirurgia (Stuttg). 1990; 33(Suppl 1):36-9. 16. Mimatsu K, Yoshida T, Namba K, Kasai T. Laminectomy performed using a micro bone saw. Int Orthop. 2000; 24(1):54-7. 17. Padanyi C, Vajda J, Banczerowski1 P. Para-Split laminotomy: a rescue technique for split laminotomy approach in exploring intramedullary midline located pathologies. J Neurol Surg A Cent Eur Neurosurg. 2014; 75(4):310-6. 18. Adachi K, Futami T, Ebihara A, Yamaya T, Kasai N, Nakazawa T, et al. Spinal canal enlargement procedure by restorative laminoplasty for the treatment of lumbar canal stenosis. Spine J. 2003; 3(6):471-8. 19. Hara M, Takayasu M, Takagi T, Yoshida J. En bloc laminoplasty performed with threadwire saw. Neurosurgery. 2001; 48(1):235-9. 20. O’Leary PF, McCance SE. Distraction laminoplasty for decompression of lumbar spinal stenosis. Clin Orthop Relat Res. 2001; 384(1):26-34. 21. Dujovny M, Agner C. The use of high power drills for laminectomy in spinal stenosis: technical report. Neurol Res. 1997; 19(2):219-21. 22. Matthes M, Pillich DT, El Refaee E, Schroeder HW, Müller JU. Heat generation during bony decompression of lumbar spinal stenosis using a high-speed diamond drill with or without automated irrigation and an ultrasonic bone-cutting knife: a single-blinded prospective randomized controlled study. World Neurosurg. 2018; 111(1):e72-81. 23. Tomita K, Toribatake Y, Kawahara N, Ohnari H, Kose H. Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis. Spinal Cord. 1994; 32(1):36-46. 24. 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. | ||
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