The Experts below are selected from a list of 237 Experts worldwide ranked by ideXlab platform
Hiroshi Nakagawa - One of the best experts on this subject based on the ideXlab platform.
-
Recapping hemilaminoplasty for spinal surgical disorders using ultrasonic Bone Curette.
Surgical neurology international, 2012Co-Authors: Hidenori Matsuoka, Yasunobu Itoh, Shinichi Numazawa, Masato Tomii, Kazuo Watanabe, Yoshitaka Hirano, Hiroshi NakagawaAbstract:OBJECTIVE The authors present a novel method of the recapping hemilaminoplasty in a retrospective study of patients with spinal surgical disorders. This report describes the surgical technique and the results of hemilaminoplasty using an ultrasonic Bone Curette. The aim of this study was to examine the safety and effectiveness of the hemilaminoplasty technique with ultrasonic Bone Curette. METHODS Between April 2003 and July 2011, 33 patients with various spinal diseases (17 spinal tumors, 5 dural arteriovenous fistulas, 3 syringomyelia, 2 sacral perineural cysts, and 2 arachnoid cysts) were treated microsurgically by using an ultrasonic Bone Curette with scalpel blade and lightweight handpiece. The ultrasonic Bone Curette was used for division of lamina. After resection of the lesion, the excised lamina was replaced exactly in situ to its original anatomic position with a titanium plate and screw. Additional fusion technique was not required and the device was easy to handle. All patients were observed both neurologically and radiologically by dynamic plain radiographs and computed tomography (CT) scan. RESULTS The operation was performed successfully and there were no instrument-related complications such as dural laceration, nerve root injury, and vessels injury. The mean number of resected and restored lamina was 1.7. CT confirmed primary Bone fusion in all patients by 12 months after surgery. CONCLUSION The ultrasonic Bone Curette is a useful instrument for recapping hemilaminoplasty in various spinal surgeries. This method allows anatomical reconstruction of the excised Bone to preserve the posterior surrounding tissues.
-
Surgical pitfalls of an ultrasonic Bone Curette (SONOPET) in spinal surgery. Commentary
Neurosurgery, 2006Co-Authors: Kyongsong Kim, Toyohiko Isu, Masanori Isobe, Ryoji Matsumoto, Kazunari Kogure, Volker K. H. Sonntag, Edward C. Benzel, Hiroshi NakagawaAbstract:OBJECTIVE: We report our experience with the SONOPET ultrasonic Bone Curette. METHODS: Between September 2001 and July 2005, 546 patients underwent microscopic spinal surgeries using a high-speed drill and the SONOPET instrument. RESULTS: We encountered operative complications thought to be attributable to the use of the SONOPET in six patients (1.1%). There were five instances of dural puncture and one spinal cord injury. All dural tears occurred when the dura mater was aspirated into the tip of the SONOPET. None of the affected patients developed postoperative clinical complications because cerebrospinal fluid leakage was avoided by appropriate closure. We think that the transient spinal cord injury occurred because the vibration emanating from the SONOPET was transmitted directly to the spinal cord. Some patients experienced damage to the epidural venous plexus for reasons similar to those described above. CONCLUSION: SONOPET facilitates the removal of Bone in a narrow field, such as that encountered during keyhole surgery. It aids in the removal of the lateral edge of Bone and is especially useful for expanding the foramen intervertebrale or opening the lateral recess. However, its use is not without risk. To prevent dural tears and venous plexus injury, we recommend that cotton be placed between the SONOPET and important structures. To avoid spinal cord injury, we suggest that the SONOPET be inserted horizontal with the dura mater to avoid the direct transmission of vibrations emanating from the instrument to the spinal cord. SONOPET is suitable for decompression on the lateral side, but not for decompression above the spinal cord.
-
ultrasonic Bone curettage for optic canal unroofing and anterior clinoidectomy technical note
Journal of Neurosurgery, 2006Co-Authors: Han Soo Chang, Joon Suk Song, Tatsushi Inoue, Masahiro Joko, Hiroshi NakagawaAbstract:✓Extradural unroofing of the optic canal and subsequent mobilization of the optic nerve is a useful technique in the surgical treatment of parasellar tumors; however, the drilling procedure itself is associated with the risk of optic nerve damage. A safer technique would certainly be beneficial. The ultrasonic Bone Curette is a device developed in Japan for safer Bone removal. Its use in intradural anterior clinoidectomy and opening of the internal auditory meatus has been reported before. In this article the authors describe their experience in using this device for extradural unroofing of the optic canal in patients with parasellar tumors. Between March 2002 and November 2004, the aforementioned technique was used in the treatment of eight patients with parasellar tumors. After undertaking a frontotemporal craniotomy and orbital osteotomy, an ultrasonic Bone Curette was used to unroof the optic canal via an epidural approach; in five cases anterior clinoidectomy was added subsequently. Using an ultrason...
-
Ultrasonic Bone curettage for optic canal unroofing and anterior clinoidectomy: Technical note
Journal of neurosurgery, 2006Co-Authors: Han Soo Chang, Joon Suk Song, Tatsushi Inoue, Masahiro Joko, Kiyoshi Ito, Hiroshi NakagawaAbstract:Extradural unroofing of the optic canal and subsequent mobilization of the optic nerve is a useful technique in the surgical treatment of parasellar tumors; however, the drilling procedure itself is associated with the risk of optic nerve damage. A safer technique would certainly be beneficial. The ultrasonic Bone Curette is a device developed in Japan for safer Bone removal. Its use in intradural anterior clinoidectomy and opening of the internal auditory meatus has been reported before. In this article the authors describe their experience in using this device for extradural unroofing of the optic canal in patients with parasellar tumors. Between March 2002 and November 2004, the aforementioned technique was used in the treatment of eight patients with parasellar tumors. After undertaking a frontotemporal craniotomy and orbital osteotomy, an ultrasonic Bone Curette was used to unroof the optic canal via an epidural approach; in five cases anterior clinoidectomy was added subsequently. Using an ultrasonic Bone Curette, unroofing of the optic canal was completed safely and required much less expertise than that required for standard drilling. The mortality and major morbidity rates were 0%. The visual function outcome was satisfactory, with the overall visual status improving in all seven patients in whom this symptom was present preoperatively. The ultrasonic Bone Curette makes the unroofing of the optic canal safer and easier, possibly improving the visual outcome of patients undergoing surgery for parasellar tumors.
-
Technical advantages of an ultrasonic Bone Curette in spinal surgery
Journal of neurosurgery. Spine, 2005Co-Authors: Hiroshi Nakagawa, Sang Don Kim, Junichi Mizuno, Yukoh Ohara, Kiyoshi ItoAbstract:Object. The authors discuss the safety and efficacy of an ultrasonic Bone Curette in various spinal surgeries and report its advantages in clinical application. Methods. Between April 2002 and September 2003, 76 patients with various spinal diseases (29 cervical, five thoracic, 40 lumbosacral, and two foramen magnum regions) were treated microsurgically by using a Sonopet ultrasonic Bone Curette with longitudinal and torsional tips and lightweight handpieces. The operations were performed successfully and the device was easy to handle. There were no instrument-related complications or -induced damage to any structure even when removing osseous spurs or ossified lesions near the dura mater, nerves, and vessels. Conclusions. The ultrasonic Curette is a useful instrument for procedures performed near the dura mater or other neural tissue without excessive heat production or mechanical injury. This device is recommended for various spinal surgeries in addition to high-speed drills or other tools.
Kyongsong Kim - One of the best experts on this subject based on the ideXlab platform.
-
Microsurgical Medial Fenestration with an Ultrasonic Bone Curette for Lumbar Foraminal Stenosis
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi, 2012Co-Authors: D. Morimoto, Atsushi Sugawara, Toyohiko Isu, Ryoji Matsumoto, Kyongsong Kim, Masanori IsobeAbstract:Background: Misdiagnosis and inadequate treatment of lumbar foraminal stenosis (LFS) are the most common causes of failed back surgery. Although several surgical procedures have been reported, the optimal surgical treatment remains controversial. Aim: We describe our method of microsurgical medial fenestration using an ultrasonic Bone Curette (Sonopet, Stryker Corp., Kalamazoo, MI, USA) to treat patients with LFS and report our early results. Patients and Methods: We followed up 26 patients who had undergone microsurgical medial fenestration at least 1 year earlier. The patients were 15 men and 11 women with a mean age at surgery of 59.5 years; the mean follow-up period was 30.6 months. The affected nerve root was at L4 in 1 patient and at L5 in 25. Evaluation of our clinical results was based on the Japanese Orthopedic Association score. Results: There were no intraoperative surgery-related complications. After surgery, 1 patient had recurrence of L5 radiculopathy associated with iatrogenic spondylolysis. He was successfully treated with resection of the inferior articular process without fusion surgery; there was loss of disc height without obvious instability at the corresponding level. The Japanese Orthopedic Association scores showed significant improvement at 1 month after surgery and at final follow-up (p
-
microsurgical medial fenestration with an ultrasonic Bone Curette for lumbar foraminal stenosis
Journal of Nippon Medical School, 2012Co-Authors: D. Morimoto, Atsushi Sugawara, Toyohiko Isu, Ryoji Matsumoto, Kyongsong Kim, Masanori IsobeAbstract:Background: Misdiagnosis and inadequate treatment of lumbar foraminal stenosis (LFS) are the most common causes of failed back surgery. Although several surgical procedures have been reported, the optimal surgical treatment remains controversial. Aim: We describe our method of microsurgical medial fenestration using an ultrasonic Bone Curette (Sonopet, Stryker Corp., Kalamazoo, MI, USA) to treat patients with LFS and report our early results. Patients and Methods: We followed up 26 patients who had undergone microsurgical medial fenestration at least 1 year earlier. The patients were 15 men and 11 women with a mean age at surgery of 59.5 years; the mean follow-up period was 30.6 months. The affected nerve root was at L4 in 1 patient and at L5 in 25. Evaluation of our clinical results was based on the Japanese Orthopedic Association score. Results: There were no intraoperative surgery-related complications. After surgery, 1 patient had recurrence of L5 radiculopathy associated with iatrogenic spondylolysis. He was successfully treated with resection of the inferior articular process without fusion surgery; there was loss of disc height without obvious instability at the corresponding level. The Japanese Orthopedic Association scores showed significant improvement at 1 month after surgery and at final follow-up (p<0.001). No patient had spinal instability or malalignment postoperatively. Conclusions: Microsurgical medial fenestration using Sonopet, a less-invasive surgical technique that does not result in spinal instability or malalignment, yielded excellent clinical outcomes.
-
Cervical anterior fusion with the Williams-Isu method: clinical review.
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi, 2012Co-Authors: Kyongsong Kim, Atsushi Sugawara, Toyohiko Isu, D. Morimoto, Shiro Kobayashi, A. TeramotoAbstract:Anterior decompression and fusion of the cervical spine is a widely accepted treatment for cervical canal disease. The Williams-Isu method involves cervical anterior fusion with autologous Bone grafts from cervical vertebral bodies. Its advantages are a wide operative field, excellent graft fusion, the absence of problems related to the iliac donor site, and direct visualization of the nerve root. For detailed decompression of the cervical root, an ultrasonic Bone Curette (SONOPET, Stryker Japan K.K., Tokyo) may be useful. To prevent graft extrusion, bioabsorbable screws featuring a head are placed in 4 corners of the Bone graft and are fixed with a tap on a part of the graft. The screws are visualized on postoperative X-ray, computed tomography, and magnetic resonance imaging studies. In 69 patients reported elsewhere there were no complications attributable to screw insertion, screw or graft extrusion, or surgery-related infections. When adequate Bone cannot be harvested, a piece of ceramic hydroxyapatite is placed between the Bone grafts. This sandwich method reinforces the graft, and radiological evidence suggests that it yields better results with respect to the angle and height of the fused segment. For the surgical treatment of cervical ossification of the posterior longitudinal ligament, a large vertebral Bone window and a large Bone graft are needed; this may result in postoperative radiological worsening. Radiological studies have shown that cervical ossification of the posterior longitudinal ligament can, as can cervical spondylosis, be addressed with the Williams-Isu method. Detailed radiological studies in patients treated with the Williams-Isu method have demonstrated that the range of motion and the disc height of the fused segment must be considered to prevent worsening in that segment after anterior fusion. The Williams-Isu method cannot completely correct cervical alignment, and great caution must be exercised in patients with preoperative malalignment. To reduce the levels to be fused in patients with multilevel lesions due to cervical disease, the Williams-Isu method can be combined with the transvertebral approach. The transvertebral approach facilitated by the wide Williams-Isu window allows the root bifurcation area to be confirmed during the early stage of surgery and possible decompression along the root. Radiological examination has shown that the combination of the Williams-Isu method and transvertebral approach does not affect the fusion level compared with the Williams-Isu method alone and produces better results than does the transvertebral approach alone.
-
Latest treatment of lumbar canal stenosis
Brain and nerve = Shinkei kenkyu no shinpo, 2009Co-Authors: Kyongsong Kim, Toyohiko IsuAbstract:Lumbar canal stenosis (LCS) is a degenerative disease involving the lumbar vertebrae, discs, and ligamentum flavum that result in neurological deficit to some extent. The natural history of symptoms of LCS is highly important because they do not necessarily worsen with progressive degeneration. Therefore, a observation therapy is adopted for the treatment of this condition. Although invasive treatment is required for some patients, surgery cannot be performed solely on the basis of radiological findings and careful evaluation of neurological symptoms is necessary. In the event that spinal surgery is required, it is important to minimize degree of invasiveness; various devices and operative approaches and methods have been developed to this end. Our strategy for the surgical treatment of LCS involves microscopic decompression via a posterior approach. In our method, modified bilateral decompression via the splitting of the spinous process using an ultrasonic Bone Curette (SONOPET), and the results of this approach have been excellent. Our method is less invasive, facilitates the preservation of the paraspinal muscle, and represents a useful approach to posterior spinal elements. Our findings indicate that this method involves less muscle damage as compared to other methods. LCS should be differentiated from conditions other than those involving the spinal canal such as foraminal stenosis and far-out syndrome, piriformis syndrome, and tarsal tunnel syndrome. The incidence of these conditions is higher than appreciated and they present with neurological deficits similar to observed in LCS. Here, we report our criteria of operative indications for surger and the procedures that we developed for the treatment of LCS, based on a review of the available literature.
-
anterior vertebral artery decompression with an ultrasonic Bone Curette to treat bow hunter s syndrome
Acta Neurochirurgica, 2008Co-Authors: Kyongsong Kim, Toyohiko Isu, D. Morimoto, S. Kominami, S. Kobayashi, A. TeramotoAbstract:We report a patient with bow hunter’s syndrome who was treated by anterior decompression of the vertebral artery (VA) using an ultrasonic Bone Curette (SONOPET). This 60-year-old man reported almost losing consciousness upon head rotation. Although the right VA appeared normal at the natural head position, upon left head rotation it became completely occluded at the transverse foramen of C2. We performed anterior decompression of the right VA at the axis using a high-speed drill and SONOPET. For anterior decompression of the VA in a deep and narrow operative field, we recommend use of SONOPET, which permits safe, easy Bone dissection.
Toyohiko Isu - One of the best experts on this subject based on the ideXlab platform.
-
Microsurgical Medial Fenestration with an Ultrasonic Bone Curette for Lumbar Foraminal Stenosis
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi, 2012Co-Authors: D. Morimoto, Atsushi Sugawara, Toyohiko Isu, Ryoji Matsumoto, Kyongsong Kim, Masanori IsobeAbstract:Background: Misdiagnosis and inadequate treatment of lumbar foraminal stenosis (LFS) are the most common causes of failed back surgery. Although several surgical procedures have been reported, the optimal surgical treatment remains controversial. Aim: We describe our method of microsurgical medial fenestration using an ultrasonic Bone Curette (Sonopet, Stryker Corp., Kalamazoo, MI, USA) to treat patients with LFS and report our early results. Patients and Methods: We followed up 26 patients who had undergone microsurgical medial fenestration at least 1 year earlier. The patients were 15 men and 11 women with a mean age at surgery of 59.5 years; the mean follow-up period was 30.6 months. The affected nerve root was at L4 in 1 patient and at L5 in 25. Evaluation of our clinical results was based on the Japanese Orthopedic Association score. Results: There were no intraoperative surgery-related complications. After surgery, 1 patient had recurrence of L5 radiculopathy associated with iatrogenic spondylolysis. He was successfully treated with resection of the inferior articular process without fusion surgery; there was loss of disc height without obvious instability at the corresponding level. The Japanese Orthopedic Association scores showed significant improvement at 1 month after surgery and at final follow-up (p
-
microsurgical medial fenestration with an ultrasonic Bone Curette for lumbar foraminal stenosis
Journal of Nippon Medical School, 2012Co-Authors: D. Morimoto, Atsushi Sugawara, Toyohiko Isu, Ryoji Matsumoto, Kyongsong Kim, Masanori IsobeAbstract:Background: Misdiagnosis and inadequate treatment of lumbar foraminal stenosis (LFS) are the most common causes of failed back surgery. Although several surgical procedures have been reported, the optimal surgical treatment remains controversial. Aim: We describe our method of microsurgical medial fenestration using an ultrasonic Bone Curette (Sonopet, Stryker Corp., Kalamazoo, MI, USA) to treat patients with LFS and report our early results. Patients and Methods: We followed up 26 patients who had undergone microsurgical medial fenestration at least 1 year earlier. The patients were 15 men and 11 women with a mean age at surgery of 59.5 years; the mean follow-up period was 30.6 months. The affected nerve root was at L4 in 1 patient and at L5 in 25. Evaluation of our clinical results was based on the Japanese Orthopedic Association score. Results: There were no intraoperative surgery-related complications. After surgery, 1 patient had recurrence of L5 radiculopathy associated with iatrogenic spondylolysis. He was successfully treated with resection of the inferior articular process without fusion surgery; there was loss of disc height without obvious instability at the corresponding level. The Japanese Orthopedic Association scores showed significant improvement at 1 month after surgery and at final follow-up (p<0.001). No patient had spinal instability or malalignment postoperatively. Conclusions: Microsurgical medial fenestration using Sonopet, a less-invasive surgical technique that does not result in spinal instability or malalignment, yielded excellent clinical outcomes.
-
Cervical anterior fusion with the Williams-Isu method: clinical review.
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi, 2012Co-Authors: Kyongsong Kim, Atsushi Sugawara, Toyohiko Isu, D. Morimoto, Shiro Kobayashi, A. TeramotoAbstract:Anterior decompression and fusion of the cervical spine is a widely accepted treatment for cervical canal disease. The Williams-Isu method involves cervical anterior fusion with autologous Bone grafts from cervical vertebral bodies. Its advantages are a wide operative field, excellent graft fusion, the absence of problems related to the iliac donor site, and direct visualization of the nerve root. For detailed decompression of the cervical root, an ultrasonic Bone Curette (SONOPET, Stryker Japan K.K., Tokyo) may be useful. To prevent graft extrusion, bioabsorbable screws featuring a head are placed in 4 corners of the Bone graft and are fixed with a tap on a part of the graft. The screws are visualized on postoperative X-ray, computed tomography, and magnetic resonance imaging studies. In 69 patients reported elsewhere there were no complications attributable to screw insertion, screw or graft extrusion, or surgery-related infections. When adequate Bone cannot be harvested, a piece of ceramic hydroxyapatite is placed between the Bone grafts. This sandwich method reinforces the graft, and radiological evidence suggests that it yields better results with respect to the angle and height of the fused segment. For the surgical treatment of cervical ossification of the posterior longitudinal ligament, a large vertebral Bone window and a large Bone graft are needed; this may result in postoperative radiological worsening. Radiological studies have shown that cervical ossification of the posterior longitudinal ligament can, as can cervical spondylosis, be addressed with the Williams-Isu method. Detailed radiological studies in patients treated with the Williams-Isu method have demonstrated that the range of motion and the disc height of the fused segment must be considered to prevent worsening in that segment after anterior fusion. The Williams-Isu method cannot completely correct cervical alignment, and great caution must be exercised in patients with preoperative malalignment. To reduce the levels to be fused in patients with multilevel lesions due to cervical disease, the Williams-Isu method can be combined with the transvertebral approach. The transvertebral approach facilitated by the wide Williams-Isu window allows the root bifurcation area to be confirmed during the early stage of surgery and possible decompression along the root. Radiological examination has shown that the combination of the Williams-Isu method and transvertebral approach does not affect the fusion level compared with the Williams-Isu method alone and produces better results than does the transvertebral approach alone.
-
Latest treatment of lumbar canal stenosis
Brain and nerve = Shinkei kenkyu no shinpo, 2009Co-Authors: Kyongsong Kim, Toyohiko IsuAbstract:Lumbar canal stenosis (LCS) is a degenerative disease involving the lumbar vertebrae, discs, and ligamentum flavum that result in neurological deficit to some extent. The natural history of symptoms of LCS is highly important because they do not necessarily worsen with progressive degeneration. Therefore, a observation therapy is adopted for the treatment of this condition. Although invasive treatment is required for some patients, surgery cannot be performed solely on the basis of radiological findings and careful evaluation of neurological symptoms is necessary. In the event that spinal surgery is required, it is important to minimize degree of invasiveness; various devices and operative approaches and methods have been developed to this end. Our strategy for the surgical treatment of LCS involves microscopic decompression via a posterior approach. In our method, modified bilateral decompression via the splitting of the spinous process using an ultrasonic Bone Curette (SONOPET), and the results of this approach have been excellent. Our method is less invasive, facilitates the preservation of the paraspinal muscle, and represents a useful approach to posterior spinal elements. Our findings indicate that this method involves less muscle damage as compared to other methods. LCS should be differentiated from conditions other than those involving the spinal canal such as foraminal stenosis and far-out syndrome, piriformis syndrome, and tarsal tunnel syndrome. The incidence of these conditions is higher than appreciated and they present with neurological deficits similar to observed in LCS. Here, we report our criteria of operative indications for surger and the procedures that we developed for the treatment of LCS, based on a review of the available literature.
-
anterior vertebral artery decompression with an ultrasonic Bone Curette to treat bow hunter s syndrome
Acta Neurochirurgica, 2008Co-Authors: Kyongsong Kim, Toyohiko Isu, D. Morimoto, S. Kominami, S. Kobayashi, A. TeramotoAbstract:We report a patient with bow hunter’s syndrome who was treated by anterior decompression of the vertebral artery (VA) using an ultrasonic Bone Curette (SONOPET). This 60-year-old man reported almost losing consciousness upon head rotation. Although the right VA appeared normal at the natural head position, upon left head rotation it became completely occluded at the transverse foramen of C2. We performed anterior decompression of the right VA at the axis using a high-speed drill and SONOPET. For anterior decompression of the VA in a deep and narrow operative field, we recommend use of SONOPET, which permits safe, easy Bone dissection.
Man Luo - One of the best experts on this subject based on the ideXlab platform.
-
three dimensional navigation o arm versus fluoroscopy in the treatment of thoracic spinal stenosis with ultrasonic Bone Curette a retrospective comparative study
Medicine, 2019Co-Authors: Bingtao Wen, Zhongqiang Chen, Chuiguo Sun, Kaiji Jin, Jun Zhong, Xin Liu, Lei Tan, Peng Yang, Man LuoAbstract:Three-dimensional intraoperative navigation (O-arm) has been used for many years in spinal surgeries and has significantly improved its precision and safety. This retrospective study compared the efficacy and safety of spinal cord decompression surgeries performed with O-arm navigation and fluoroscopy. The clinical data of 56 patients with thoracic spinal stenosis treated from March 2015 to April 2017 were retrospectively analyzed. Spinal decompression was performed with O-arm navigation and ultrasonic Bone Curette in 29 patients, and with ultrasonic Bone Curette and fluoroscopy in 27 patients. Patients were followed-up at postoperative 1 month, 3 months, and the last clinic visit. The neurologic functions were assessed using the Japanese Orthopaedic Association (JOA) Back Pain Evaluation Questionnaire. The accuracy of screw placement was examined using three-dimensional computed tomography (CT) on postoperative day 5. There was no significant difference in the incidences of intraoperative dural tear, nerve root injury, and spinal cord injury between the two groups. The two groups showed no significant difference in postoperative JOA scores (P > .05). The O-arm navigation group had significantly higher screw placement accuracy than the fluoroscopy group (P < .05). O-arm navigation is superior to fluoroscopy in the treatment of thoracic spinal stenosis with ultrasonic Bone Curette in terms of screw placement accuracy. However, the two surgical modes have similar rates of intraoperative complications and postoperative neurologic functions.
-
Three-dimensional navigation (O-arm) versus fluoroscopy in the treatment of thoracic spinal stenosis with ultrasonic Bone Curette: A retrospective comparative study.
Medicine, 2019Co-Authors: Bingtao Wen, Zhongqiang Chen, Chuiguo Sun, Kaiji Jin, Jun Zhong, Xin Liu, Lei Tan, Peng Yang, Man LuoAbstract:Three-dimensional intraoperative navigation (O-arm) has been used for many years in spinal surgeries and has significantly improved its precision and safety. This retrospective study compared the efficacy and safety of spinal cord decompression surgeries performed with O-arm navigation and fluoroscopy. The clinical data of 56 patients with thoracic spinal stenosis treated from March 2015 to April 2017 were retrospectively analyzed. Spinal decompression was performed with O-arm navigation and ultrasonic Bone Curette in 29 patients, and with ultrasonic Bone Curette and fluoroscopy in 27 patients. Patients were followed-up at postoperative 1 month, 3 months, and the last clinic visit. The neurologic functions were assessed using the Japanese Orthopaedic Association (JOA) Back Pain Evaluation Questionnaire. The accuracy of screw placement was examined using three-dimensional computed tomography (CT) on postoperative day 5. There was no significant difference in the incidences of intraoperative dural tear, nerve root injury, and spinal cord injury between the two groups. The two groups showed no significant difference in postoperative JOA scores (P > .05). The O-arm navigation group had significantly higher screw placement accuracy than the fluoroscopy group (P
Kiyoshi Ito - One of the best experts on this subject based on the ideXlab platform.
-
Safe and minimally invasive laminoplastic laminotomy using an ultrasonic Bone Curette for spinal surgery: technical note.
Surgical neurology, 2009Co-Authors: Kiyoshi Ito, Shigetoshi Ishizaka, Tetsuo Sasaki, Takahiro Miyahara, Tetsuyoshi Horiuchi, Keiichi Sakai, Hiroaki Shigeta, Kazuhiro HongoAbstract:Abstract Background Ultrasonic surgical aspirators have been used mainly for removing brain tumors. Because of their longitudinal and torsional tip, they are used for cutting the Bone structures in spinal surgery installing a scalpel-type tip. The purpose of this report is to describe the effectiveness and surgical pitfalls of an ultrasonic Bone Curette in laminoplastic laminotomy and hemilaminotomy. Methods We present 12 patients who underwent laminoplastic laminotomy and hemilaminotomy. We used a SONOPET UST-2001 ultrasonic Bone Curette with HB-05S handpieces (M and M Co, Ltd, Tokyo, Japan). After a tumor was removed, titanium plates were used for the laminoplastic laminotomy and hemilaminotomy. The technical advantage of an ultrasonic Bone Curette and procedure-related complication were examined. Results There were no major procedure-related complications such as cord injury. Wound infection and subcutaneous fluid collection caused by cerebrospinal fluid leakage did not occur for reconstruction of posterior bony structure. In 1 patient with calcified dura mater associated with tumor, dural tear occurred. The width of the tip was narrow enough for resected laminae to be fused postoperatively, and spinal instability did not occur in all cases. Conclusion The scalpel-type ultrasonic Bone Curette is useful for cutting Bone and effective for reconstruction of the laminae. Laminotomy with an ultrasonic Bone Curette is safe and minimally invasive. To prevent dural tear, we recommend drilling laminae to make the Bone thin as the first step, followed by cutting the remaining laminae using a Bone Curette especially in cases with calcified or tense dura mater.
-
Ultrasonic Bone curettage for optic canal unroofing and anterior clinoidectomy: Technical note
Journal of neurosurgery, 2006Co-Authors: Han Soo Chang, Joon Suk Song, Tatsushi Inoue, Masahiro Joko, Kiyoshi Ito, Hiroshi NakagawaAbstract:Extradural unroofing of the optic canal and subsequent mobilization of the optic nerve is a useful technique in the surgical treatment of parasellar tumors; however, the drilling procedure itself is associated with the risk of optic nerve damage. A safer technique would certainly be beneficial. The ultrasonic Bone Curette is a device developed in Japan for safer Bone removal. Its use in intradural anterior clinoidectomy and opening of the internal auditory meatus has been reported before. In this article the authors describe their experience in using this device for extradural unroofing of the optic canal in patients with parasellar tumors. Between March 2002 and November 2004, the aforementioned technique was used in the treatment of eight patients with parasellar tumors. After undertaking a frontotemporal craniotomy and orbital osteotomy, an ultrasonic Bone Curette was used to unroof the optic canal via an epidural approach; in five cases anterior clinoidectomy was added subsequently. Using an ultrasonic Bone Curette, unroofing of the optic canal was completed safely and required much less expertise than that required for standard drilling. The mortality and major morbidity rates were 0%. The visual function outcome was satisfactory, with the overall visual status improving in all seven patients in whom this symptom was present preoperatively. The ultrasonic Bone Curette makes the unroofing of the optic canal safer and easier, possibly improving the visual outcome of patients undergoing surgery for parasellar tumors.
-
Technical advantages of an ultrasonic Bone Curette in spinal surgery
Journal of neurosurgery. Spine, 2005Co-Authors: Hiroshi Nakagawa, Sang Don Kim, Junichi Mizuno, Yukoh Ohara, Kiyoshi ItoAbstract:Object. The authors discuss the safety and efficacy of an ultrasonic Bone Curette in various spinal surgeries and report its advantages in clinical application. Methods. Between April 2002 and September 2003, 76 patients with various spinal diseases (29 cervical, five thoracic, 40 lumbosacral, and two foramen magnum regions) were treated microsurgically by using a Sonopet ultrasonic Bone Curette with longitudinal and torsional tips and lightweight handpieces. The operations were performed successfully and the device was easy to handle. There were no instrument-related complications or -induced damage to any structure even when removing osseous spurs or ossified lesions near the dura mater, nerves, and vessels. Conclusions. The ultrasonic Curette is a useful instrument for procedures performed near the dura mater or other neural tissue without excessive heat production or mechanical injury. This device is recommended for various spinal surgeries in addition to high-speed drills or other tools.