Effect of Ultrasonic Osteotome on Therapeutic Efficacy and Safety of Spinal Surgery: A System Review and Meta-Analysis

Abstract

Background. A meta-analysis was performed to evaluate the effectiveness and safety of ultrasonic osteotomes in spine surgery to standard spinal surgery procedures. Methods. Using the search keywords “bone curette”, “cutter”, “scalpel”, “bone shaver”, “aspirator”, “osteotome”, “ultrasonic”, “piezosurgery”, and “ ${\text{dent}\hspace{0.17em}\hspace{0.17em}}^{\ast }$ ” in the databases of PubMed (1966-2021.12), Cochrane Library, Embase (1986-2018.12), Web of Science (1978-2021.12), and China Academic Journals Full-Text Database (CNKI, 1979-2021.12). Two researchers reviewed the literature, extracted and extensively assessed the data, and included information on the study quality. RevMan v5.3.5.0 was used for the meta-analysis. Results. A total of 10 trials with a total of 911 patients were included. The meta-analysis findings revealed that, when compared to traditional methods, ultrasonic osteotomes could save operation time ( $\text{OR}=-18.83$ , 95 percent CI (-22.76, -14.99), $P=0.03$ ) and reduce intraoperative bleeding ( $\text{OR}=-66.73$ , 95 percent CI (-75.70, -57.76), $P=0.04$ ) and postoperative complications ( $\text{OR}=0.38$ , 95 percent CI (0.21, 0.69), $P=0.001$ ). There was, however, no significant difference in the hospital stay ( $\text{OR}=-1.34$ , 95 percent CI (-1.90, -0.77), $P=0.23$ ) and symptom improvement rate ( $\text{OR}=1.03$ , 95 percent CI (0.73, 1.45), $P=0.86$ ). Conclusion. There is evidence that using an ultrasonic osteotome in spine surgery is safe and effective and may minimize intraoperative bleeding and save time. However, there is no significant difference in symptom improvement rate, hospital stay length, or postoperative complications compared to standard surgical equipment. Therefore, more high-quality investigations are needed to corroborate the initial results.