Clinical Analysis Of Piezoelectric Surgery And Recapping Laminoplastyin Intraspinal Tumor Resection

Objective: To compare the clinical outcome of 32 cases underwent intraspinal tumour resection by ultrasonic bone curette or traditional bone rongeur,and evaluate the postoperative bony fusion and recovery of neurological function.Effect factors concerning safety and reliability of ultrasonic bone curette were also made.Method: A total of 32 patients underwent intraspinal tumour resection were enrolled from September 2015 to September 2016 at the department of Neuro-oncology,the First Hospital of Jilin University.All the patients were divided into two groups: investigation group(ultrasonic bone curette,16 cases)and control group(bone rongeur,16cases).In accordance with classification of American Spine Injury Association,spinal nerve function of all subjects was evaluated.All the surgeries were performed by the professor and associate professor.In investigation group,posterior laminectomy was performed by using ultrasonic bone curette.After resecting spinal tumour,the composition of spinous process and lamina was fixed by titanium plate and titanium nails.With these procedures,recovery and formation of spinal canal could be achieved finally.As to control group,bone rongeur was used to conduct the traditional laminectomy and exposed spinal dura.Formation of spinal canal did not appear after surgery.The demographic and clinical data were recorded.Also,the time required for full exposure of spinal dura,amount of bleeding,the condition of intraoperative dural injury,ASIA classification of patients after 3 to 6 months and the extend of bony fusion of control group were all evaluated.All the results were analysed by SPSS 18.0.Result:32 cases of resection were performed in this study.There is an obvious advantage in investigation group concerning ultrasonic bone curette compared to control group,with less intraoperative bleeding(P<0.05).Have not increase the rate of spinal dura injury.While the long-term neurological function of both group was well maintained.In addition,although the total time of exposure to spinal dura was equal(P>0.05),there was a significant less operative time and intraoperative bleding in ultrasonic bone curette compared with bone rongeur when removed more than 5 segments.Many advantages were appeared such as higher cutting precision,more efficient,less fatigue of hand,less bleeding,more clear operation field and the protectiveness for soft tissue,and so on,especially for multiple segmental lamina excision in intraspinal tumor resection.In follow-up of 3 ~ 6 months the complex of spinous process and vertebral plate was healed well in several patients among investigation group,1 case of minor iatrogenic spinal canal stenosisoccured,butthepatient has no obvious symptoms of nerve.Conclusion: As a new type of surgical instruments,ultrasonic treatment can be safely and effectively remove the complex of spinous process and vertebral plate,can shorten the operation time,reduce bleeding,in addition,its organization selectivity and cavitational effect can protect nerve and vascular in the process of surgery,and are beneficial of the achievement of implant the complex.It's significance for rebuilding of spinal anatomical structure and the maintenance of spinal stability.Therefore,the application of UBC and implanting of the complex of spinous process and vertebral plate should be promote in the intraspinal tumour resection.