Efficacy and Safety Analysis of Ultrasonic Bone Curette in the Treatment of Thoracic Spinal Stenosis

Abstract

Objective To investigate the efficacy and safety of ultrasonic bone curette in treating thoracic spinal stenosis. Methods A total of 30 patients of thoracic spinal stenosis who underwent posterior thoracic decompression in the hospital from December 2015 to 2017 were enrolled. Of these, 18 patients (group A) underwent posterior thoracic decompression using ultrasonic bone curette; and 12 patients underwent the treatment using a high‐speed drill (group B). The time of laminectomy, amount of intraoperative blood loss, presence or absence of cerebrospinal fluid leakage, and nerve root injury were recorded. All patients underwent X‐ray, computed tomography with three‐dimensional reconstruction, and magnetic resonance imaging before and after surgery. The Frankel classification and the Japanese Orthopaedic Association (JOA) scores were used to assess the neurological function and neurological recovery in patients. The measured data were statistically processed and analyzed using SPSS21.0 software, and the measurement data were expressed as mean ± SD. Results In groups A and B, the average time for single‐segment laminectomy was 3.3 ± 1.2 min and 6.0 ± 1.8 min and the mean bleeding volume was 105.5 ± 43.3 mL and 177.4 ± 54.7 mL, respectively, with a statistically significant difference between the groups. The difference in JOA scores before and after surgery in groups A and B was statistically significant. No significant difference was found between the groups, in group A, the improvement rate of nerve function at the last follow‐up was 71% and in group B, the improvement rate at the last follow‐up was 70%. In group A, at last follow‐up, two patients had Frankel grade B injury, one had grade C injury, seven had grade D injury, and eight had grade E injury. In group B, at last follow‐up, one patient had Frankel grade B injury, one had grade C injury, five had grade D injury, and five had grade E injury. The Frankel classification of both groups A and B significantly improved. Four patients experienced cerebrospinal fluid leakage in group A and five in group B, with no significant difference between the groups. There was no nerve root injury in both groups, and no complications, such as pulmonary infection and urinary tract infection, occurred after operation. Conclusions With the use of ultrasonic bone curette in posterior thoracic decompression, the decompression surgery could be completed relatively safely and quickly. It effectively reduced the amount of intraoperative blood loss.

Keywords

• Thoracic spinal stenosis
• High‐speed drill
• Posterior thoracic decompression
• Ultrasonic bone curette