Misonix has announced that after a comparative study in 100 consecutive patients, Ajay Krishnan of the Stavya Spine Hospital and Research Center in India has concluded that the BoneScalpel is better than conventional methods in terms of safety and efficacy as it reduces the number of dural tears and neurological deficit, reduces blood loss and shortens operating time. The results, first presented at the 27th Annual Conference of the Association of Spine Surgeons of India (ASSICON), which was held in conjunction with the World Conference of the Scoliosis Research Society from January 23–26, 2014 in Kolkata, India, were just recently released and have been submitted for publication in a scientific journal.
The retrospective study was conducted between 2013 and 2014 to assess whether the use of the ultrasonic BoneScalpel has the potential to improve peri-operative outcomes in decompression of thoracic spinal stenosis, which is frequently associated with postoperative worsening in 15–20% of cases. A total of 100 consecutive cases were examined, 55 using BoneScalpel and 45 using conventional manual bone punches. Following a short learning curve with comparable results between both methods, use of the BoneScalpel led to a reduction in the occurrence of dural tears and an absence of neurological worsening post surgery. Blood loss was reduced by 27.5%. Total operative time was reduced by 22%, operative time per spinal segment by 28.5%. The increase in efficiency can be attributed to the surgeon’s ability to resect bone in large segments (en-bloc) rather than being limited to the smaller bite sizes of 2–3mm bone punches as performed in conventional microscopic surgery.
Better outcomes with reduced risk of complications and improvements in operative efficiency are major challenges for hospitals and surgeons throughout the world. Incidental dural tears add to the length of hospital stay and represent additional expense for these procedures. Increased blood loss leads to higher anaesthesia risks, increased use of blood transfusions and, with that, higher risk of disease transmission or adverse reactions. Increase in blood loss, blood transfusion and operative time are further associated with an increased risk for surgical site infections. Therefore, studies concluding that the BoneScalpel can improve peri-operative outcomes and operating room efficiency indicate significant economic benefit to healthcare systems around the globe.
Summarising his study findings, Krishan explains, “All orthopaedic surgeons are well familiar with the difference between a traditional plaster cutter and an oscillating cast saw. Likewise, the ultrasonic BoneScalpel is a precise, tissue-specific bone cutting tool, and in fact, a quite magical tool in my armamentarium. It has empowered me as a surgeon, making potentially dangerous thoracic spine procedures into more predictable, safer procedures with better patient outcomes. In addition the BoneScalpel reduces overall blood loss and surgical time, thus reducing patient morbidity and hospital stay.”