• H Nakase, R Matsuda, Y Shin, Y-S Park, and T Sakaki.
• Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan. nakasehi@naramed-u.ac.jp
• Acta Neurochir (Wien). 2006 Feb 1; 148 (2): 207-12; discussion 212-3.

ObjectThe author describes a clinical applications, procedure, and efficacy of ultrasonic bone curette (UBC) (bone-removal bar) in spinal surgery.MethodsFrom July 2003 to March 2005, we operated on 98 consecutive spinal disorders by using UBC, Sonopet UST-2001; Chiari type-1 malformation (6 cases), cervical disorders (64 cases), thoracic disorders (5 cases), and lumbar disorders (23 cases). The instrument was devoid of any spinning parts, and the risk of grabbing cotton pledgets and damaging normal tissue was thereby avoided. Support from assistants for irrigation and suction was not required.FindingsIn this series, there were no iatrogenically induced injuries for example, direct or heat damage to surrounding soft tissues, including nerves, vessels, spinal cord, and dura matter. Considering potential complications of mechanical injuries by ultrasonic technique, intermittent usage and cotton protection during use under an operating microscope are recommended. We found that the ultrasonic device is easy to handle; however, it is time consuming for removing a large amount of bone and ossified lesions. Therefore, we recommend the combined use of this method with standard drilling.ConclusionsThis system appears to be versatile, safe, and efficient in spinal surgery and could be improved by the development of a better handpiece.

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