The Comparison Of Application Of Ultrasonic Bone Curette And High-speed Drill In Surgery Of Thoracic Ossification Of Ligamentum Flavum

Object:To investigate the safety and efficacy of the ultrasonic bone curette in the operation of thoracic ossification of ligamentum flavum,and the advantages of technology than the traditional high-speed drill.Methods:The authors retrospectively reviewed the records of 74 patients who diagnosed thoracic ossification of ligamentum flavum according to the clinical symptomms and thoracic imaging data,and underwent thoracic lamina resection decompression using an ultrasonic bone curette or a high-speed drill by the same doctor at our Hospital between October 2015 and October 2017.The ultrasonic bone curette treatment group had 21 cases,and the high-speed drill group had 53 cases.The lamina excision time,blood loss,the hospital length of stay(LOS)and the rate of complications such as dural injury and cerebrospinal fluid leakage were noted,and postoperative JOA score and the rate of postoperative neurological improvement were followed.Results:There were 10 males and 11 females in group I,there were 21 males and 32 females in group II.There was no statistical difference(P=0.530).The average age was 56.38±8.32 years(group I)and 59.00±7.47 years(group II)respectively,and the finding was not statistically significant(P=0.192).The average duration of the disease was 34.24±37.96(group I)and 30.38±31.30(group II)respectively(P=0.654).The average vertebral segment was 2.48±1.08(group I)and 2.55±1.12(group II)respectively(P=0.804).The preoperative JOA score of group I was 5.67±1.71,and the preoperative JOA score of group II was 6.09±1.94(P=0.844).The average blood loss for each segment was 129.44±40.27ml(group I)and 186.28±35.46ml(group II)respectively,and the finding was statistically significant(P=0.000).The average time for each segment was 6.09±2.27min(group I)and 9.92±3.70min(group II)respectively,and this finding was statistically significant(P=0.000).There were 4 cases(19.05%)of dural injury or cerebrospinal fluid leakage in group I,and 11 cases(20.75%)of dural injury or CSF leak or spinal cord injury in group II,the finding of the rate of complications was no statistically significant(P=0.948).Among,0 cases and 2 cases(3.77%)were found in group I and group II respectively(P=0.367).Postoperative JOA score was 9.24±1.48(group I)and 8.92±1.94(group II)respectively,the finding was no statistical significance(P=0.507).The LOS was 19.24±7.87 days(group I)and 20.64±7.14 days(group II)respectively(P=0.461).Conclution:The ultrasonic bone curette reduced the operation time and the bleeding amount compared with the high-speed drill in thoracic lamina resection decompression.The ultrasonic bone curette was more advantage than the high-speed drill in decompression.The decompression operation of thoracic ossification of ligamentum flavum was performed safely and effectively by using the ultrasonic bone curette.