Applications of the ultrasonic bone cutter in spinal surgery--our preliminary experience.

OBJECTIVE: To present our experience with the Misonix Ultrasonic Bone scalpel in spinal surgery, highlighting its potential applications and advantages.

METHODS: Between March and December 2011, a total of 937 spinal cases were performed at a single centre. The Misonix Bone Scalpel (MBS) was used in 62 of these cases. Data were collected prospectively using the Spine Tango registry. Patient demographics, disease type, surgery performed and complications were all recorded along with pre- and post-operative core measures outcome index (COMI).

RESULTS: The majority of cases were for spinal degenerative disorders, in particular, revision cases. The bone cutter was also used to achieve laminotomies for access to intradural tumours, corpectomies and a mixture of other pathologies. Of the 62 patients only 1 (1.6%) experienced a blood loss greater than 500 ml, and there was only 1 dural tear (1.6%) as a direct result of the MBS. Four illustrative cases are discussed.

CONCLUSIONS: The MBS is a useful adjunct in spinal surgery with particular value in revision cases where scar tissue distorts the normal anatomy. There was a low complication rate with a trend to reduced blood loss. This was most apparent to the senior authors during cervical and thoracic corpectomies.