Ultrasonic osteotome versus high-speed burr in cervical anterior vertebral subtotal resection: A retrospective study of 81 cases

2020 ◽  
Vol 66 (5) ◽  
pp. 369-372
Author(s):  
X. Liu ◽  
B.-T. Wen ◽  
Z.-Q. Chen ◽  
L. Tan ◽  
J. Zhong
2019 ◽  
Vol 31 (6) ◽  
pp. 831-834 ◽  
Author(s):  
Anand H. Segar ◽  
Alexander Riccio ◽  
Michael Smith ◽  
Themistocles S. Protopsaltis

Total uncinate process resection or uncinectomy is often required in the setting of severe foraminal stenosis or cervical kyphosis correction. The proximity of the uncus to the vertebral artery, nerve root, and spinal cord makes this a challenging undertaking. Use of a high-speed burr or ultrasonic bone dissector can be associated with direct injury to the vertebral artery and thermal injury to the surrounding structures. The use of an osteotome is a safe and efficient method of uncinectomy. Here the authors describe their technique, which is illustrated with an intraoperative video.


2013 ◽  
Vol 40 (4) ◽  
pp. 384-391 ◽  
Author(s):  
S. M. Cha ◽  
H. D. Shin ◽  
K. C. Kim ◽  
I. Y. Park

The purpose of this retrospective study was to compare the clinical and radiological outcomes of patients treated with different adjuvant methods after curettage for enchondromas of the hand. Sixty-two patients with enchondroma were treated with high-speed burring (29 patients) or alcohol instillation (33 patients) after curettage. The mean follow-up was 40.8 months. No significant differences in the visual analogue scale, Disabilities of the Arm, Shoulder, and Hand scores, total range of active motion, grip strength, and complete healing time were observed between the groups. The distribution of the results of the formula by Wilhelm and Feldmeier were not significantly different between the groups. No surgery-related complications, postoperative pathological fractures, or recurrence was found in either group. For the treatment of enchondroma in the metacarpal and proximal phalanx, alcohol instillation immediately after curettage was as effective as extensive curettage using a high-speed burr.


2018 ◽  
Vol 24 (3) ◽  
pp. 83-90 ◽  
Author(s):  
A. Yu. Mushkin ◽  
D. G. Naumov ◽  
E. Yu. Umenushkina

Purpose of the study— to study impact of hemi-vertebrae extirpation technique in mono-segmental reconstructionon the surgical trauma.Material and Methods.34 patients underwent 36 mono-segmental extirpations of hemi-vertebrae followed by aposterior fixation during a single center four years cohort study. Mean age of children at the moment of procedure was 4 years and 3 months (min — 1 year, max — 14 years). The authors studied impact of pathology level, surgical approach, type of bony structures removal technique and age of the patients on the time of procedure and volume of blood loss. Results.Extirpation of thoracic hemi-vertebrae was characterized by a lengthier procedure and greater blood lossin contrast to lumbar hemi-vertebrae. Patients were divided into three groups depending on extirpation technique: 1)  extirpation from two approaches using a high-speed burr; 2) from a single dorsal approach using the same extirpation technique; 3) from dorsal approach using ultrasonic bone scalpel. Surgery time was 208±72 min in the first group, 187±54 min in the second group, and 170±30 min in the third group; blood loss volume was 181±39, 181±53, 132±73 ml respectively in the groups, or 11.5±4.3%, 9.4±2.8% and 9.6±5.2% of total blood volume, respectively.Conclusion.Surgical approach and hemi-vertebrae extirpation technique in children have a varying impact onsurgery time and intraoperative blood loss, and the least values were reported for posterior approach using ultrasonic bone scalpel.


2020 ◽  
Author(s):  
Yuhao Yuan ◽  
Feng Long ◽  
Qing Liu ◽  
Ziyi Wu ◽  
Hongbo He ◽  
...  

Abstract Background The aim of this retrospective study was to evaluate the efficacy of precise open excision surgery to treat osteoid osteoma with C-arm assisted precise localization during the operation. Methods From June 2010 to June 2017, patients with osteoid osteoma of the extremities who had undergone treatment by high speed burr grinding, full scratching with curette, and C-arm assisted lesion localization during the operation were analyzed retrospectively. The preoperative and postoperative pain was assessed by the visual analogue scale (VAS) scoring. The patients were followed up regularly, and the advantages, effects, and complications of the therapeutic technique were analyzed. Results The study consisted of 94 patients (59 males, 35 females; mean age, 17.6 ± 8.5 years) and they were followed up for a mean of 38.9 months (range, 24–72 months). All patients were diagnosed with osteoid osteoma by postoperative pathological examination. Follow-up consisted of imaging reexamination and clinical evaluation. If the patients did not take non-steroidal anti-inflammatory drugs (NSAIDs) before the operation, the mean pre-operative VAS score was 6.7, and the mean VAS score of all patients was 0 one month after operation. The mean time for all patients to resume normal daily activities was 14.3 days (range, 10–21 days). There was no recurrence of pain, infection, vascular or nerve injury, and fracture complications during the follow-up. In only one case of distal femur osteoid osteoma (OO), review X-ray found a suspected recurrence 50 months after the primary surgery and subsequently, the patient underwent a second surgery. Till date, the patient has reported no discomfort following the second surgery. Conclusions For treatment of osteoid osteoma, open incision and minimal resection with C-arm assisted tumor localization is still a suitable method, especially for osteoid osteoma located on the surface of the cortical bone.


1997 ◽  
Vol 7 (4) ◽  
pp. 153-157 ◽  
Author(s):  
P.R. Williams ◽  
M.V.S. Maheson

Eighty two cemented femoral revision hip arthroplasties were reviewed to assess the incidence of intraoperative perforation of the femur and subsequent periprosthetic fracture using a high speed pneumatic burr for the removal of acrylic bone cement with an extensile exposure. There was one case of intraoperative femoral perforation; this patient did not go onto fracture postoperatively. There were no cases of intraoperative femoral fracture. There were 3 cases of periprosthetic femoral fracture all of which occurred more than 12 months after their impaction grafted femoral revision arthroplasty using a standard length cemented stem. The pneumatic high speed burr was extremely effective in the removal of acrylic bone cement in femoral revision arthroplasty. The incidence of subsequent femoral fracture in the impaction grafted revised population was low and did not appear to be related to intraoperative femoral perforation.


2020 ◽  
Author(s):  
Pai-han Wang ◽  
Chia-Lun Wu ◽  
Chao-Ming Chen ◽  
Jir‐You Wang ◽  
Po-Kuei Wu ◽  
...  

Abstract BackgroundBone tumors are often treated with intralesional curettage. High-speed burring, an adjuvant therapy, was performed to maximize the tumor cell killing; however, tumor recurrence might still occur, which may be caused by residual tumor or local tumor spread during surgery.MethodsA porcine cadaver (femur) was utilized to determine whether the use of a high-speed burr causes bone cement spray. To mimic residual tumor after curettage, luminescent cement was smeared on two locations of the bone cavity, the wall and the bottom. The cavity in the femoral bone was then placed in the middle of a sheet of drawing paper featuring 10 cm, 20 cm, and 30 cm concentric circles. The luminescent cement was then burred totally with a high-speed burr.ResultsThe intensity of the area in the wall in circle I was 72.6% ± 5.8%; within circle II, it was 22.1% ± 4.2%; and within circle III, it was 5.4% ± 1.5%. The intensity of the area within the bottom of the femoral bone within circle I was 66.5% ± 6.1%, within circle II was 28.1 ± 4.8%, and within circle III, it was 5.4% ± 1.4%. The amount of luminescent cement seeding decreased with distance, but there was no difference while burring at different locations of the bone cavity. Under the handpiece cover, a greater amount of cement spray was retained in circle I during burring of the cement in the bottom of the cavity and less was sprayed out in circle III.ConclusionsHigh-speed burring may cause tumor seeding, which could extend to 20 cm. The intensities of spray did not decrease, even when the handpiece cover was used. The correlation between high-speed burring and tumor seeding was highly suspect in this pilot study.


2020 ◽  
Author(s):  
Yuhao Yuan ◽  
Feng Long ◽  
Qing Liu ◽  
Ziyi Wu ◽  
Hongbo He ◽  
...  

Abstract PurposeThe aim of this retrospective study was to evaluate the efficacy of precise open excision surgery to treat osteoid osteoma with C-arm assisted precise localization during the operation.MethodsFrom June 2010 to June 2017, patients with osteoid osteoma of the extremities who had undergone treatment by high speed burr grinding, full scratching with curette, and C-arm assisted lesion localization during the operation were analyzed retrospectively. The preoperative and postoperative pain was assessed by the visual analogue scale (VAS) scoring. The patients were followed up regularly, and the advantages, effects, and complications of the therapeutic technique were analyzed.ResultsThe study consisted of 94 patients (59 males, 35 females; mean age, 17.6 ± 8.5 years) and they were followed up for a mean of 38.9 months (range, 24–72 months). All patients were diagnosed with osteoid osteoma by postoperative pathological examination. Follow-up consisted of imaging reexamination and clinical evaluation. If the patients did not take non-steroidal anti-inflammatory drugs (NSAIDs) before the operation, the mean pre-operative VAS score was 6.7, and the mean VAS score of all patients was 0 one month after operation. The mean time for all patients to resume normal daily activities was 14.3 days (range, 10-21 days). There was no recurrence of pain, infection, vascular or nerve injury, and fracture complications during the follow-up. In only one case of distal femur osteoid osteoma (OO), review X-ray found a suspected recurrence 50 months after the primary surgery and subsequently, the patient underwent a second surgery. Till date, the patient has reported no discomfort following the second surgery.ConclusionsFor treatment of osteoid osteoma, open incision and minimal resection with C-arm assisted tumor localization is still a suitable method, especially for osteoid osteoma located on the surface of the cortical bone.


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