Skip to main content


Log in

Use of an ultrasonic osteotome device in spine surgery: experience from the first 128 patients

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript



The ultrasonic BoneScalpel is a tissue-specific device that allows the surgeon to make precise osteotomies while protecting collateral or adjacent soft tissue structures. The device is comprised of a blunt ultrasonic blade that oscillates at over 22,500 cycles/s with an imperceptible microscopic amplitude. The recurring impacts pulverize the noncompliant crystalline structure resulting in a precise cut. The more compliant adjacent soft tissue is not affected by the ultrasonic oscillation. The purpose of this study is to report the experience and safety of using this ultrasonic osteotome device in a variety of spine surgeries.


Data were retrospectively collected from medical charts and surgical reports for each surgery in which the ultrasonic scalpel was used to perform any type of osteotomy (facetectomy, laminotomy, laminectomy, en bloc resection, Smith Petersen osteotomy, pedicle subtraction osteotomy, etc.). The majority of patients had spinal stenosis, degenerative or adolescent scoliosis, pseudoarthrosis, adjacent segment degeneration, and spondylolisthesis et al. Intra-operative complications were also recorded.


A total of 128 consecutive patients (73 female, 55 male) beginning with our first case experience were included in this study. The mean age of the patients was 58 years (range 12–85 years). Eighty patients (62.5 %) had previous spine surgery and/or spinal deformity. The ultrasonic scalpel was used at all levels of the spine and the average levels operated on each patient were 5. The mean operation time (skin to skin) was 4.3 h and the mean blood loss was 425.4 ml. In all cases, the ultrasonic scalpel was used to create the needed osteotomies to facilitate the surgical procedure without any percussion on the spinal column or injury to the underlying nerves. There was a noticeable absence of bleeding from the cut end of the bone consistent with the ultrasonic application. There were 11 instances of dural injuries (8.6 %) and two of which were directly associated with the use of ultrasonic device. In no procedure was the use of the ultrasonic scalpel abandoned for use of another instrument due to difficulty in using the device or failure to achieve the desired osteotomy.


Overall, the ultrasonic scalpel was safe and performed as desired when used as a bone cutting device to facilitate osteotomies in a variety of spine surgeries. However, caution should be taken to avoid potential thermal injury and dural tear. If used properly, this device may decrease the risk of soft tissue injury associated with the use of high speed burrs and oscillating saws during spine surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Hosono N, Miwa T, Mukai Y, Takenaka S, Makino T, Fuji T (2009) Potential risk of thermal damage to cervical nerve roots by a high-speed drill. J Bone Joint Surg Br 91:1541–1544

    PubMed  CAS  Google Scholar 

  2. Hara M, Takayasu M, Takagi T, Yoshida J (2001) En bloc laminoplasty performed with threadwire saw. Neurosurg 48:235–239

    CAS  Google Scholar 

  3. Dammous S, Darche V, R. G (2010) Use of ultrasonic bone scalpel in orthognatic surgery. Proceedings of the XX Congress of the European Association of Cranio-Maxillo-Facial Surgery, Bruges, Belgium, Medimond International Proceedings

  4. Sanborn MR, Balzer J, Gerszten PC, Karausky P, Cheng BC, Welch WC (2011) Safety and efficacy of a novel ultrasonic osteotome device in an ovine model. J Clin Neurosci 18:1528–1533

    Article  PubMed  Google Scholar 

  5. Satomi K, Ogawa J, Ishii Y, Hirabayashi K (2001) Short-term complications and long-term results of expansive open-door laminoplasty for cervical stenotic myelopathy. Spine J 1:26–30

    Article  PubMed  CAS  Google Scholar 

  6. Horton JE, Tarpley TM Jr, Jacoway JR (1981) Clinical applications of ultrasonic instrumentation in the surgical removal of bone. Oral Surg Oral Med Oral Pathol 51:236–242

    Article  PubMed  CAS  Google Scholar 

  7. Sherman JA, Davies HT (2000) Ultracision: the harmonic scalpel and its possible uses in maxillofacial surgery. Br J Oral Maxillofac Surg 38:530–532

    Article  PubMed  CAS  Google Scholar 

  8. Stubinger S, Kuttenberger J, Filippi A, Sader R, Zeilhofer HF (2005) Intraoral piezosurgery: preliminary results of a new technique. J Oral Maxillofac Surg 63:1283–1287

    Article  PubMed  Google Scholar 

  9. Vercellotti T, Pollack AS (2006) A new bone surgery device: sinus grafting and periodontal surgery. Compend Contin Educ Dent 27:319–325

    PubMed  Google Scholar 

  10. McMahon P, Dididze M, Levi AD (2012) Incidental durotomy after spinal surgery: a prospective study in an academic institution. J Neurosurg 17:30–36

    Google Scholar 

Download references

Conflict of interest

The authors declare that there is no direct conflict of interest associated with this manuscript.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Isador H. Lieberman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hu, X., Ohnmeiss, D.D. & Lieberman, I.H. Use of an ultrasonic osteotome device in spine surgery: experience from the first 128 patients. Eur Spine J 22, 2845–2849 (2013).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: