The Application Of Piezosurgery Technique In Cervical And Thoracic Surgery

Background:The degenerative diseases of the cervical and thoracic vertebral body, intervertebral disc lesions and cervical thoracic tumor are common clinical diseases. Generally, these diseases have the characteristic of insidious onset and slow development. The clinical symptoms is relatively obvious at the late of the disease, which significantly injures spinal cord function, brings great pain to the patient and seriously affects the patients’ quality of life. Non-surgical treatments have little satisfactory prognosis of the disease. Cervical and thoracic vertebrae have complex anatomic structure, common congenital anomalies and mutation, which brings greater difficulties to the surgery. Traditional orthopedic surgical instruments such as rongeur, osteotome, abrasive drilling, incises bone by the higher mechanical strength, taking large irreversible damage of the surrounding soft tissue, like the blood vessels and nerves, which increases the chance of the complications. The use of the piezosurgery greatly reduces the probability of occurrence of the surgery risk. It’s characteristic of the selectively cutting bone reduces the soft tissue injury, improve the operation efficiency and enhance the effect of surgical treatment.Objective:To analyse the application of the piezosurgery on the cervical and thoracic surgery and conclude the characteristics of the piezosurgery application in the cervical, thoracic surgery.Method:we selected15cases with completed cervical, thoracic surgery medical records from nearly one hundred cases of the difficult vertebral surgery in our orthopaedic trauma department of the second hospital of Shandong University.Results: This group of cases, including8male patients,7female patients, which age is between39-81and the average age is58. We have finished4cases of the cervical spondylotic myelopathy and1case of the esophageal compressed type cervical pondylopathy used anterior approach cervical operation,6cases of the cervical spondylotic myelopathy used posterior approach cervical operation and1case of the thoracic spinal canal stenosis and3cases of thoracic tumor used posterior thoracic surgery. All of the patients after surgery obtained obviously effect, without intraoperative and postoperative complications and the recovery of spinal cord function is also obvious. The average operation time was146minutes and the average intraoperative blood loss was168milliliters in the10cases of the cervical spondylotic myelopathy with surgical treatment used piezosurgery. There are3cases of the10need blood transfusion and the average volume of blood transfusion of the all is120milliliters.Conclusion:Piezosurgery technique is a comprehensive technology to carry out safe and effective orthopaedic surgery based on piezosurgery as the main instrument on the key operation steps of accurate surgery and assisted with traditional orthopedic instruments such as the bone chisel, curet and rongeur, which has the high security and reliability. Using piezosurgery technique can smoothly and efficiently finish the difficult spinal surgery and achieve satisfactory operation effect.