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Subaxial Cervical Laminectomy Using a Misonix BoneScalpel®: A Guide to Operative Technique
Brian Fiani1, Alexander Newhouse2, Alessandra Cathel1
1Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, CA, USA.
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.
