Targeted bone resection

Surgical procedures on the spine are routine operations and yet due to the proximity of important sensitive neurovascular structures, they are always very challenging. They therefore require intelligent solutions, such as the ultrasonic technology from Söring. This method offers the significant advantage that different effects are displayed distinctly and to varying degrees on various types of tissue. Bone is primarily affected by mechanical removal, whereas mostly no mechanical effect is visible on tissue containing collagen with high elastin content (e. g. blood vessels, nerve fibres, dura mater). Due to lower temperature at the tissue tip interface compared to other technologies there is also low risk of heat related damage. This allows precise preparation of the bone in the immediate vicinity of extremely delicate structures on the spine.

"The use of Söring’s ultrasonic-assisted bone instrument changes the surgical procedure. Excessive bone matter is no longer milled, but precisely removed entirely by the instrument."

Dr Jan-Uwe Müller, deputy director of the department of neurosurgery, University Medicine Greifswald, Germany

Highlights

  • non-rotating technology
  • optimized for an effect on bone
  • precise bone removal*
  • precise cuts with straight cutting surface
  • lower temperature development*
  • bone on the cut surface remains vital*
  • pressure-free working in tight spaces
  • bone harvesting in pieces

Principle of ultrasonic technology in spinal surgery

The ultrasonic oscillations of the sonotrode tip combined with the manual movement of the bone instrument allow a precise and controlled cutting through bone and a targeted bone removal. Elastic structures are significantly more resistant to ultrasonic oscillations. Since they can adapt to the oscillations, they remain intact in the event of contact with the sonotrode tip.

Indications for ultrasonic spine surgery

  • resection of osteophytes
  • (anterior) cervical decompression
  • anterior cervical foraminotomy
  • uncoforaminotomy
  • foraminotomy
  • laminotomy
  • laminectomy
  • laminoplasty
  • lumbar decompression
  • accesses for fusions
  • removal of vital bone fragments for fusion operations

References

* Matthes, M., Pillich, D. T., El Refaee, E., Schroeder, H. W.S., Müller, J.-U.: Heat Generation During Bony Decompression of Lumbar Spinal Stenosis Using a High-Speed Diamond Drill with or without Automated Irrigation and an Ultrasonic Bone-Cutting Knife: A Single-Blinded Prospective Randomized Controlled Study. World Neurosurgery 2018; 111: e72-e81, https://doi.org/10.1016/j.wneu.2017.11.172