Application of ultrasonic bone scalpel in thoracolumbar spine decompression surgery: a systematic review and meta-analysis

Study Design: This is a systematic review and meta-analysis of comparative studies that investigates the efficacy of ultrasonic bone scalpel (UBS) as a tool for decompressive spine surgery. Purpose: The study aims to compare the outcomes of UBS with conventional methods of decompression, such as high-speed drill (HSD) and osteotome. Overview of Literature: We discuss the traditional methods of removing bone during decompressive spine surgery using instruments such as osteotome, rongeurs, and drills. We highlight the advantages of UBS, which selectively cuts bony tissues and spares the adjacent soft tissues, thereby avoiding their inadvertent injury. Methods: A systematic literature search was conducted in electronic databases, including PubMed, Embase, Scopus, and Google Scholar, to identify potentially eligible comparative studies. Data from eligible studies were extracted into spreadsheets, and a meta-analysis was performed using appropriate computer software. Results: The final analysis included seven studies, involving a total of 1024 patients. The results indicate that the UBS group had significantly shorter mean operating time and significantly reduced incidence of complications when compared to osteotome. However, there was no significant difference in the safety profile of UBS and HSD. Conclusions: UBS is a novel technology that shows promising results in terms of efficiency and complication rates in decompressive spine surgery. It has a comparable, if not better, safety profile than conventional methods such as osteotome and HSD and leads to quicker surgeries.