Abstract
BACKGROUND: Piezosurgery (PS) has gained increasing dispersion in neurosurgery.
In pediatric neurosurgery, the experience is limited to craniosynostosis surgery.
The present study assesses PS in the pediatric population, also considering
outcomes and complications in cranial and spinal procedures.
METHODS: All consecutive craniotomies and laminotomies, performed with PS (group
A) or conventional osteotomes (group B) in the 2014-2017 period were reviewed.
The following variables were analyzed: dural tears, estimated blood loss and need
of transfusion, cosmetic outcome (Sloan score), and operative times. A review of
the pertinent literature is included.
RESULTS: 172 children were enrolled, 90 in group A and 82 in group B. The mean
follow-up time was 2.1 years. A statistically significant difference in favor of
group A was found about EBL (105 vs. 113 ml) and late outcome (Sloan class A
98.5% vs. 91.5%). PS also reduced the risk of dural tears (1 vs. 7 cases in
groups A and B, respectively) and blood transfusion (52% vs. 55.5%) but without
statistical significance. The operative times were significantly shorter in group
B (13 vs. 23 minutes), although the newer PS plus (PSP) was demonstrated to
significantly shorten these times compared with the traditional PS (3.5 vs. 6.5
minutes for orbitotomy and 7.5 vs. 9.5 minutes for hemicraniotomy).
CONCLUSIONS: PS is a safe and effective tool that can be specifically recommended
for bone splitting and graft, laminotomy, and craniotomy in cosmetically eloquent
areas. The limit of operation times can be overcome by a learning curve in
neurosurgery and PSP.
Lingua originale | English |
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pagine (da-a) | e625-e633 |
Rivista | World Neurosurgery |
Volume | 126 |
DOI | |
Stato di pubblicazione | Pubblicato - 2019 |
Keywords
- Adolescent
- Bone graft
- Bone harvesting
- Child
- Child, Preschool
- Craniofacial surgery
- Craniotomy
- Female
- Humans
- Infant
- Laminectomy
- Male
- Neurosurgery
- Neurosurgical Procedures
- Osteointegration
- Pediatrics
- Piezosurgery
- Retrospective Studies