A Comparative Study of Piezoelectric Surgery versus High-Speed Drill in Cervical Spine Laminectomy

Piezoelectric bone surgery is an emerging technique that facilitates the selective cutting of mineralized tissue while preserving soft tissue integrity. Conventional tools such as the high-speed drill (HSD) and Kerrison rongeur are associated with complications, such as dural tears and neurovascular injury. This study compares intraoperative and post-operative (operative time, blood loss, complications, and post-operative pain) outcomes of cervical laminectomy performed using piezoelectric surgery (PS) versus high-speed drilling.

A prospective comparative study was done, including forty-two patients with cervical spondylotic myelopathy, who were enrolled from January 2019 to January 2025 for standard laminectomy levels from C3 to C6. They were allocated into two groups using the alternating allocation method. Twenty-one underwent primary laminectomy using a piezoelectric device (Piezotome), and twenty-one underwent laminectomy using an HSD.

The piezoelectric group (n = 21; 8 women, 13 men) had a mean age of 63 years and a mean pre-operative Japanese Orthopaedic Association (mJOA) score of 12.4 ± 2.4. The HSD group (n = 21; 5 women, 16 men) had a mean age of 61.2 years and a mJOA score of 12.2 ± 2.8. Laminectomy time per level was significantly shorter in the piezoelectric group (2.2 ± 0.8 min) compared to the HSD group (6.4 ± 2.2 min). Mean blood loss (after subtracting irrigated amount of Normal saline) was 220 mL in the piezoelectric group versus 412 mL in the HSD group. No dural tears occurred in the piezoelectric group, while two were reported in the HSD group. Post-operative pain (visual analog scale at 24 h) was also lower in the piezoelectric cohort (P < 0.05).

PS demonstrates superior safety and efficiency in cervical laminectomy, with reduced operative time, blood loss, and complication rates compared to traditional high-speed drilling.