Subaxial Cervical Laminectomy Using a Misonix BoneScalpel®: A Guide to Operative Technique.

INTRODUCTION: Cervical laminectomy is a surgical technique that is used to decompress the spinal cord. The standard equipment for making bony cuts includes a high-speed drill (HSD) or osteotome; the ultrasonic BoneScalpel® (UBS) by Misonix (Farmingdale, NY) may be used for this purpose either alone or in combination with other instruments.

OBJECTIVE: We describe the operative technique and principles behind the use of the Misonix BoneScalpel (MBS) for subaxial cervical laminectomy.

METHODS: The features, functions and mechanism of the MBS are described. Use of a UBS for en bloc subaxial cervical laminectomy is outlined, including a description of the technique, the avoidance of complications, and perioperative considerations.

RESULTS: Use of the MBS in cervical decompression is a safe and effective alternative to HSD when considering tissue selectivity, thermal control, and coagulative effects.

CONCLUSION: While the initial upfront cost of the MBS is greater than that of similar equipment, the potential long-term savings in time and resources can yield a cost-effective return. The MBS should be progressively incorporated into the surgical protocol as dictated by the surgeon's comfort level.