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

Background: An oscillating bone saw is rarely used to perform laminectomy. The purpose of this study was to describea relatively quick and harmless technique for multilevel laminectomy in patients with lumbar spinal stenosis (LSS) usingan oscillating bone saw to find out how this instrument affects the time of surgery and rate of complications.Methods: This prospective study was conducted on 45 patients with LSS who required multilevel laminectomy. Thebones were cut using an oscillating sagittal saw equipped with a fine 1-cm blade. Posterolateral fusion was performed ifany evidence of spinal instability occurred, or the correction of deformity was addressed. The time spent for laminectomyfrom initial cutting to the whole bone removal (T1) and the duration of laminectomy (i.e., from initiation to the end ofdecompression; T2) were recorded for the corresponding level. The volume of harvested autograft was also measured,and any dural injuries were reported.Results: Posterolateral fusion was performed on 32 (71.1%) patients. The mean T1 and T2 per level were estimated at70.5±5.4 and 157.5±12.1 sec, respectively. In addition, the mean volume of harvested autograft per level was obtainedas 3.5±1.2 cc. No durotomy was observed during laminectomy using an oscillating bone saw. However, a dural tearoccurred in one patient when a Kerisson punch was utilized for ligamentum flavum removal and foraminotomy.Conclusion: Based on the findings, it can be concluded that laminectomy by means of the oscillating bone saw is asafe procedure that provides a sufficient volume of harvested autograft for fusion. This technique could also induce aremarkable reduction in the time of surgery.Level of evidence: IV

Keywords:

decompression , laminectomy , lumbar spine , oscillating saw , Stenosis