Application of Oscillating Saw for Lumbar en Bloc Laminectomy: A Case Series

Abstract

Background: An oscillating bone saw is rarely used to perform laminectomy. The purpose of this study was to describe<br />a relatively quick and harmless technique for multilevel laminectomy in patients with lumbar spinal stenosis (LSS) using<br />an oscillating bone saw to find out how this instrument affects the time of surgery and rate of complications.<br />Methods: This prospective study was conducted on 45 patients with LSS who required multilevel laminectomy. The<br />bones were cut using an oscillating sagittal saw equipped with a fine 1-cm blade. Posterolateral fusion was performed if<br />any evidence of spinal instability occurred, or the correction of deformity was addressed. The time spent for laminectomy<br />from initial cutting to the whole bone removal (T1) and the duration of laminectomy (i.e., from initiation to the end of<br />decompression; T2) were recorded for the corresponding level. The volume of harvested autograft was also measured,<br />and any dural injuries were reported.<br />Results: Posterolateral fusion was performed on 32 (71.1%) patients. The mean T1 and T2 per level were estimated at<br />70.5±5.4 and 157.5±12.1 sec, respectively. In addition, the mean volume of harvested autograft per level was obtained<br />as 3.5±1.2 cc. No durotomy was observed during laminectomy using an oscillating bone saw. However, a dural tear<br />occurred in one patient when a Kerisson punch was utilized for ligamentum flavum removal and foraminotomy.<br />Conclusion: Based on the findings, it can be concluded that laminectomy by means of the oscillating bone saw is a<br />safe procedure that provides a sufficient volume of harvested autograft for fusion. This technique could also induce a<br />remarkable reduction in the time of surgery.<br />Level of evidence: IV