Jelena Jovanovic, Miguel Angel Solano, Mike Farrell, Noel Fitzpatrick
To test the efficacy of a piezoelectric instrument (PI) for bone removal during ventral slot surgery.
The spinal cord of each explanted spinal unit was replaced with a saline-filled latex condom. In 8 disc spaces, ventral slot surgery was performed using a previously reported technique. Bone removal was achieved using a motorized burr (MB). In 8 disc spaces, bone was removed via en bloc ostectomy with a PI that selectively cuts mineralized tissue. Surgical duration and operating field visibility were recorded. Rupture of the fluid filled condom was used as a measure of iatrogenic collateral trauma. Computed tomography was used to measure ventral slot morphometry.
Mean surgical duration for PI (23.4 minutes) was significantly shorter than for MB (34.1 minutes; P = .049). Using a 4 point Likert scale (4 = excellent, 3 = good, 2 = fair, 1 = poor), median visibility score was significantly higher for PI (2) than for MB (1; P = .03). The condom burst twice (1MB, 1PI) during elevation of the dorsal longitudinal ligament; there was no significant difference between techniques for incidence of collateral trauma (P = .99). Regardless of surgical technique, there was a bias in slot deviation towards the right (i.e., the surgeon's left; P = .021).