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Article

Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series

1
Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 70121 Bari, Italy
2
Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
3
Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
4
Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80138 Napoli, Italy
5
Eastman Dental Institute, University College of London, WC1E 6BT London, UK
*
Authors to whom correspondence should be addressed.
Vet. Sci. 2020, 7(2), 68; https://doi.org/10.3390/vetsci7020068
Received: 7 April 2020 / Revised: 18 May 2020 / Accepted: 20 May 2020 / Published: 22 May 2020
Objective: To report the physical and technical principles, clinical applications, and outcomes of the minimal invasive piezoelectric osteotomy in a consecutive veterinary neurosurgical series. Methods: A series of 292 dogs and 32 cats underwent an osteotomy because a neurosurgical pathology performed with a Mectron Piezosurgery® bone scalpel (Mectron Medical Technology, Genoa, Italy) was retrospectively reviewed. Efficacy, precision, safety, and blood loss were evaluated intraoperatively by two different surgeons, on a case-by-case basis. Postoperative Rx and CT scans were used to assess the selectivity and precision of the osteotomy. A histological study on bony specimens at the osteotomized surface was carried out to evaluate the effects of piezoelectric cutting on the osteocytes and osteoblasts. All the patients underwent a six-months follow-up. A series of illustrative cases was reported. Results: All the osteotomies were clear-cut and precise. A complete sparing of soft and nervous tissues and vasculature was observed. The operative field was blood- and heat-free in all cases. A range of inserts, largely different in shape and length, were allowed to treat deep and difficult-to-reach sites. Two mechanical complications occurred. Average blood loss in dogs’ group was 52, 47, and 56 mL for traumatic, degenerative, and neoplastic lesions, respectively, whereas it was 25 mL for traumatized cats. A fast recovery of functions was observed in most of the treated cases, early on, at the first sixth-month evaluation. Histology on bone flaps showed the presence of live osteocytes and osteoblasts at the osteotomized surface in 92% of cases. Conclusions: Piezosurgery is based on the physical principle of the indirect piezo effect. Piezoelectric osteotomy is selective, effective, and safe in bone cutting during neurosurgical veterinary procedures. It can be considered a minimal invasive technique, as it is able to spare the neighboring soft tissues and neurovascular structures. View Full-Text
Keywords: craniotomy; laminectomy; neurosurgery; osteotomy; piezosurgery craniotomy; laminectomy; neurosurgery; osteotomy; piezosurgery
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MDPI and ACS Style

Crovace, A.M.; Luzzi, S.; Lacitignola, L.; Fatone, G.; Giotta Lucifero, A.; Vercellotti, T.; Crovace, A. Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series. Vet. Sci. 2020, 7, 68. https://doi.org/10.3390/vetsci7020068

AMA Style

Crovace AM, Luzzi S, Lacitignola L, Fatone G, Giotta Lucifero A, Vercellotti T, Crovace A. Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series. Veterinary Sciences. 2020; 7(2):68. https://doi.org/10.3390/vetsci7020068

Chicago/Turabian Style

Crovace, Alberto Maria, Sabino Luzzi, Luca Lacitignola, Gerardo Fatone, Alice Giotta Lucifero, Tomaso Vercellotti, and Antonio Crovace. 2020. "Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series" Veterinary Sciences 7, no. 2: 68. https://doi.org/10.3390/vetsci7020068

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