Application of Oscillating Saw for Lumbar en Bloc Laminectomy: A Case Series

Document Type : RESEARCH PAPER

Authors

1 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran 2 Faculty of Medicine,

2 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran

3 Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran

4 Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran

5 Bone and Joint Related Tissue Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: An oscillating bone saw is rarely used to perform laminectomy. The purpose of this study was to describe
a relatively quick and harmless technique for multilevel laminectomy in patients with lumbar spinal stenosis (LSS) using
an oscillating bone saw to find out how this instrument affects the time of surgery and rate of complications.
Methods: This prospective study was conducted on 45 patients with LSS who required multilevel laminectomy. The
bones were cut using an oscillating sagittal saw equipped with a fine 1-cm blade. Posterolateral fusion was performed if
any evidence of spinal instability occurred, or the correction of deformity was addressed. The time spent for laminectomy
from initial cutting to the whole bone removal (T1) and the duration of laminectomy (i.e., from initiation to the end of
decompression; T2) were recorded for the corresponding level. The volume of harvested autograft was also measured,
and any dural injuries were reported.
Results: Posterolateral fusion was performed on 32 (71.1%) patients. The mean T1 and T2 per level were estimated at
70.5±5.4 and 157.5±12.1 sec, respectively. In addition, the mean volume of harvested autograft per level was obtained
as 3.5±1.2 cc. No durotomy was observed during laminectomy using an oscillating bone saw. However, a dural tear
occurred in one patient when a Kerisson punch was utilized for ligamentum flavum removal and foraminotomy.
Conclusion: Based on the findings, it can be concluded that laminectomy by means of the oscillating bone saw is a
safe procedure that provides a sufficient volume of harvested autograft for fusion. This technique could also induce a
remarkable reduction in the time of surgery.
Level of evidence: IV

Keywords

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The Archives of Bone and Joint Surgery
Volume 8, Issue 3
May 2020
Pages 407-412

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History

  • Receive Date: 06 November 2018
  • Revise Date: 21 September 2019
  • Accept Date: 05 October 2019

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