Is There a Role for an Ultrasonic Bone-Cutting Device in Adult Spinal Deformity: A Safety and Reproducibility Study

Background: Ultrasonic bone-cutting devices (UBC) are new cutting tools and have low frequency ultrasonic blade. There is limited data on the safety and eectiveness of using ultrasonic bone-cutting devices in the treatment of adult spinal deformities (ASD). Objectives: This Retrospective review of prospectively collected data was designed to determine if the use of an ultrasonic bone- cutting device is safe in the adult spinal deformity population and to compare its eectiveness in blood loss reduction by using a comparison group from a prospective multicenter database of adult spinal deformity patients. Methods: Nineteen consecutive surgical ASD cases in which the UBC was used were compared with 19 propensity-matched cases from a prospective ASD database in which conventional bone cutting instruments were used. The two groups were matched based on age, ASA, and number of levels fused posteriorly. The need for blood transfusion, volume of blood transfusion if required, esti- mated blood loss (EBL), and total operating time were compared between the two groups. Data were analyzed using non-parametric Mann-Whitney U test and Spearman's Correlation test (P < 0.05). Results: There was no statistically significant dierence in any measured parameter between the two groups. While the EBL dier- ence between the two groups (925 mL in the study group vs. 1628 mL in the control group) was not statistically significant (P = 0.142), the 703 mL dierence is clinically relevant. In addition, no complications directly related to the use of the UBC were reported. Conclusions: The use of an ultrasonic bone-cutting device was shown to be safe and eective in the surgical treatment of ASD. It resulted in a 43% reduction in EBL, which was clinically relevant and statistically non-significant, without the addition of any complications. We did not identify statistical dierences in transfusion rates, EBL, or operative time, which may be due to our small sample size.