• World Neurosurg · May 2018

    Use of a Pediatric Craniotome Drill for Cervical and Thoracic Spine Decompression: Safety and Efficacy.

    • Christopher Elia, Omid R Hariri, Jason Duong, Fanglong Dong, Raed Sweiss, and Dan Miulli.
    • Division of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, USA; Division of Neurosurgery, Arrowhead Regional Medical Center, Colton, California, USA. Electronic address: celia@RUHealth.org.
    • World Neurosurg. 2018 May 1; 113: e486-e489.

    BackgroundLaminectomy, using a high-speed drill with an unprotected cutting drill bit, can be rapid and effective, but it has been associated with known complications. Another technique uses a pediatric craniotome drill with the footplate attachment. At present, there are no studies comparing clinical outcomes between these 2 stated decompressive techniques.MethodsA retrospective review was conducted at a single institution. Two cohorts of patients were considered based on the technical method of laminectomy for decompression. One group had decompression with utilization of a high-speed drill, whereas the other group had decompression with a pediatric craniotome drill with a footplate attachment. The outcomes from each group were compared based on the length of operation, estimated blood loss, and associated complications.ResultsA total of 91 patients were included in the final analysis. Forty-five of the patients underwent laminectomy using a footplate and 46, using a high-speed drill. The footplate group was associated with significantly shorter operative time (159 vs. 205 minutes; P = 0.008). In addition, the footplate technique demonstrated less estimated blood loss (254 vs. 349 mL), and less incidence of durotomies (2.2% vs. 10.9%); however, neither of these 2 outcomes achieved statistical significance.ConclusionsDespite being an older technique, there was a shorter operative time in the footplate group without increased blood loss or incidence of durotomy. Although comparable results are operator dependent, this technique is a safe alternative for performing cervical and thoracic laminectomies.Copyright © 2018 Elsevier Inc. All rights reserved.

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