Application of piezosurgery osteotomy in cervical laminoplasty: prospective, randomized, single-blind, clinical comparison study
Objective: To compare and analyze the clinical efficacy of piezosurgery osteotomy and high-speed drilling respectively in cervical laminoplasty, so as to explore the operability, safety and clinical application value of piezosurgery osteotomy in cervical laminoplasty.
Methods: A total of 60 patients with multilevel cervical stenosis from the Inner Mongolia Autonomous Region People's Hospital were randomly divided into two groups (piezosurgery osteotomy group and high-speed drill group) with 30 patients in each group. Operation time, intraoperative blood loss, postoperative drainage, complication rate, Japanese orthopaedic association (JOA) score and JOA improvement rate were compared and analyzed.
Results: The operation time in piezosurgery osteotomy group and high-speed drill group was (87±22 min) and (96±35 min), respectively, and the difference between two groups was not statistically significant (P > 0.05). The intraoperative blood loss in the piezosurgery osteotomy group was (121 ± 86 mL) lower than that (172 ± 93 mL) in the high-speed drill group (P < 0.05). The postoperative drainage in the piezosurgery osteotomy group was (155±87 mL) lower than that (246 ± 95 mL) in the high-speed drill group (P < 0.05). Postoperative JOA scores in both groups were better than those before surgery, but there were no significant differences in the postoperative JOA scores, improvement rates, and excellent rates between the two groups (P> 0.05). Dural injury developed 1 patient in high-speed drill group and cerebrospinal fluid leakage occurred after surgery. No serious complications such as spinal cord injury occurred in either group.
Conclusion: Piezosurgery osteotomy in cervical laminoplasty is safe and effective, and is superior in operation time, intraoperative blood, and postoperative drainage. Its safety and efficacy are similar to high-speed drill in cervical laminoplasty.
Keywords: Cervical laminoplasty; piezosurgery osteotomy; high-speed drill; cervical spondylotic myelopathy; safety; efficacy