NEW ENGLAND BAPTIST HOSPITAL
The general advantages of the BoneScalpel are numerous. We now use it essentially on every spine patient, and we have found in our practice that it significantly reduces operative time, decreases blood loss, and markedly increases the amount of residual local bone available for grafting. In so doing, it significantly reduces overall O.R. time and O.R. cost.
With an osteotomy, we used to assess whether to do one, two or even three osteotomies with a complex deformity. It gives you pause when you know that each osteotomy is going to add 20 to 30 or even 40 minutes of operative time, as well as the increased blood loss and the increased potential risk. But now with the BoneScalpel, we can finish in a matter of 2 minutes, essentially bloodlessly, and it significantly improves the ability to vary our approach in a controlled fashion to achieve and perform a correction.
Eric Woodard, MD
NEMOURS / ALFRED I. DUPONT HOSPITAL FOR CHILDREN
The BoneScalpel has improved operative efficiency and blood loss in complex pediatric spinal deformity surgery at our institution. Within the first few cases we recognized that this tool has tremendous value in spine surgery. It has now become my routine to use the BoneScalpel for every deformity case; and it is useful for multiple steps in the procedure. Facetectomy with the bone scalpel is easy, quick, harvests local bone graft and seals cancellous bleeding so the resected facet is not bleeding for the whole case. Ponte osteotomies have become efficient and virtually effortless as the BoneScalpel resects the pars and remainder of the articular facet, creating apical flexibility in curves without damaging the epidural veins, exiting nerve root or adjacent dura. Furthermore, when used for bone removal/cutting in vertebral column resections, rib osteotomies or thoracoplasty, the ultrasonic technology performs the meticulous work safely and efficiently, while minimizing bleeding and soft tissue trauma.
Suken Shah, MD
BoneScalpel is one of the most important advancements in spine surgery during the last few years and it will become a preferred surgical tool for the next decade and beyond.
As a neurosurgeon specializing in spinal microsurgery, I have had extensive experience with the use of BoneScalpel in spine surgery and find it to be a safe and effective ultrasonic bone dissector that, in my opinion, will soon become an integral part of the armamentarium of every well-trained spine surgeon.
The routine use of BoneScalpel has the potential to produce significant cost savings. The ability to harvest autologous bone en bloc during laminectomies and facetectomies and utilize that bone for fusion has significantly reduced our reliance on expensive fusion supplements such as recombinant bone morphogenic protein (BMP) and implanted bone stimulators. The reduction in bleeding during multilevel laminectomies has reduced the use of cell savers and the rate of blood transfusions.
Most importantly, the reduced risk of cerebrospinal fluid leak and neurological injury is expected to have significant economic beneifts, such as reduced use of tissue sealants, diminished length of hospital stay, and reduced rate of readmissions and reoperations for CSF complications. Increasingly, pay-for-performance insurance models levy penalties for “avoidable” complications such as urinary catheter and intravascular line infections. It may not be long before payment is denied for readmissions or prolongations of stay due to iatrogenic surgical complications such as cerebrospinal fluid leaks.
I believe BoneScalpel is as significant to spine surgery today as the adoption of pneumatic drill was several decades ago.
Peyman Pakzaban, MD, FAANS
RADY CHILDREN’S HOSPITAL
The ultrasonic BoneScalpel allows me to perform precise bone cuts in the spine safely and efficiently without having to hit on an osteotome close to the spinal cord, and I was pleasantly surprised by the amount of reduced blood loss in my spinal deformity surgeries as compared to using traditional mechanical bone cutting instruments.
I had suspected the ultrasonic BoneScalpel contributes to a reduction in bone bleeding and thus a reduced need for blood transfusions and cell salvage use, and the results of this study convincingly confirmed this when I compared 20 surgeries with BoneScalpel against two control groups based on my previous surgical experience.
Peter Newton, MD
METHODIST HOSPITAL HOUSTON
As a practicing neurosurgeon at Methodist Hospital Houston, I view the Misonix BoneScalpel as one of the three most important technologies to enter the spine world in the last 10 years. It has been of tremendous value to my practice particularly in adult deformity surgery where multiple laminectomies and Smith-Peterson osteotomies are needed. The BoneScalpel’s precision and coagulative effect facilitate safety and efficiency in both simple and complex procedures. In major deformity correction surgeries, such as Pedicle Subtraction Osteotomies, the bone scalpel has helped minimize blood loss and decrease the need for blood transfusion. Use of the BoneScalpel also allows for removal of bone in largery pieces which can be used locally to enhance spinal fusion.
The BoneScalpel has joined other cutting edge technologies that help our institution to maintain its leadership position and provide the best clinical outcomes for our patients.
Paul Holman, MD
CANTOR SPINE INSTITUTE
I have not performed a traditional laminectomy in almost two years and the Misonix BoneScalpel has been the game-changer. My practice focuses primarily on motion sparing and minimally invasive spine surgeries and this tool has facilitated advances previously not possible or safe. After more than 20 years of clinical practice, this technology has enabled me to design new surgical techniques that are truly much less invasive.
The BoneScalpel ultrasonic osteotome enables surgeons to isolate, and essentially dissolve, nerve-compressing lesions. A precision sculpting tool that allows safe bone cutting in a tiny space, this instrument allows access to work inside the spinal canal with less compromise of native anatomy. In my practice, traditional tools have become an adjunct to the BoneScalpel.
There is a necessary learning curve when using this tool for these more delicate applications. I have invested many hours working in a cadaver lab to perfect the technique. Time well-spent, because it has changed the way I do spine surgery. As a result of this much less invasive approach, there are multiple clear advantages for patients: safe access through a smaller incision with equal or better decompression, less post-operative pain, shorter hospital stay, less blood loss, less blood product transfusions, fewer dural tears, shorter recovery, preservation of spinal anatomy and structure resulting in fewer fusions, fewer implants, and more cost effective.
Jeffrey B. Cantor, MD, FAAOS
REID HOSPITAL & HEALTH CARE SERVICES
Of all the new technologies that have been introduced in the past ten years in spine surgery, the Misonix BoneScalpel stands out as the one that has perhaps had the most positive impact in the operating room. The BoneScalpel has significantly shortened surgical procedure time, reduced blood loss, reduced incidence of dural tears and obviated the need for allograft bone graft for spinal fusions. Highly recommend this product.
Ravishankar Vedantam, MD
Cedars-Sinai Medical Center
I have been using the Misonix BoneScalpel for multi-level laminectomies and have found that it is a very precise tool for bone-cutting and bone-shaving that gives me control and provides safety around delicate soft tissue structures.
Additionally, I think it is very impressive that there is a significant reduction of bleeding in the bone when I use this device to make my cuts. This technology has become a part of my standard of care for osteotomies.
St George’s University Hospital
The Misonix bone scalpel is a great tool for cutting bone adjacent to sensitive neural tissue. I have found it greatly enhances safety and speed whilst reducing blood loss in both deformity surgery and spinal tumour resection. As a bonus, it doesn’t turn good local bone graft into powder like a high speed drill does. If you are used to an osteotome and have used a plaster saw in the past, then it is very intuitive to pick up and use.
Fellow: Royal College of Surgeons (Orthopaedics) – 2001
Fellow: Royal College of Surgeons (Edinburgh) – 1994
Winner: G.B.Ong medal for FRCS (Edinburgh) examination
Cedars-Sinai Medical Center
The BoneScalpel is the best new tool for spinal surgery in the last 15 years.
Angeles Del Pedregal Hospital & Siglo XXI National Specialized Medical Center
By means of this letter I would like to express the importance that the BoneScalpel ultrasonic (ultrasonic bone cutter) has represented to my institutional and private practice, which I use for tumor, degenerative and trauma spine surgery. I have realized excellent results and benefits thanks to the clean cuts with minimal bleeding, and protection of the neural and vascular tissue, while reducing the surgical time. In the past I utilized drills and hand instruments for radicular and medullary decompressions which presented inherent risks to neural structures. I would like to thank you for bringing this technology to Mexico which benefits both patients and spine surgeons alike, and additionally I feel important to mention the added value you provide with your excellent service and support to ensure adequate equipment function.
Hospital Angeles Lindavista
By means of this letter I would like to share my experience with the use of the [BoneScalpel] ultrasonic scalpel in surgeries of the spine and occipital bone undertaken at the National Medical Center La Raza during 2014 and 2015. I have operated on approximately 50 patients for spine tumors via laminoplasty at the cervical, thoracic, lumbar and sacral levels, as well as surgery for decompression, corpectomies, and ventral osteophytes, including two cases involving craniotomies at the cervical level. The use of BoneScalpel has in my experience reduced the time of surgery, and minimized bone loss from one to seven levels, preserving the patient’s anatomical integrity and maintaining adequate ligament function. Another important advantage is safety obtained from keeping soft tissue (arteries, veins and never tissue) free of damage, and finally, this achieved with minimal bleeding. I consider the BoneScalpel to be an innovative, practical, safe and reliable tool for spinal surgeries.
Orthopedic Associates of Duchess County
BoneScalpel has transformed the way I approach the spine and perform complex procedures. This tool allows for the precise removal of large, geometric pieces of bone while protecting the neural elements. BoneScalpel’s ability to make such precise cuts, while sparing the surrounding soft tissue are characteristics stark in contrast to traditional spinal decompression instruments that are sharp, aggressive, and spin with high speed. Such instruments include kerrisions, chisels/gaughes, and high speed burrs. I have found that my laminectomy procedures are much faster and associated with significantly less bleeding and durotomy risk through the use of BoneScalpel.
For use in multilevel laminectomy procedures I start by making bilateral, medially directed BoneScalpel cuts at the spinolaminar lines to allow en bloc removal of the central lamina. Once the central canal is safely exposed, I probe the neural elements, lyse adhesions, and place protective cottonoid paddies in the lateral recesses. I then perform bilateral, laterally directed BoneScalpel cuts to decompress the lateral recesses and foramina. Furthermore, the value in using this tool to perform cervical laminectomies is incredible. Such procedures are often bloody, time consuming and risky. BoneScalpel cuts the surgical time on these cases in half.
Hopital Universitaire Robert Debre, Paris
My first interest in the BoneScalpel came from discussions with my experienced colleagues, experts in the management in spinal deformities, who reported significant improvement in their patients care.
I started using the BoneScalpel in my everyday practices for AIS patients and noticed from the first case the potential benefit of the technique. Every surgical step I was doing before was now performed quicker, more gently, with less blood loss and tissue damage.
The benefit is even more relevant in complex cases, such as revisions or patients requiring osteotomies, with a significant gain of time and patient safety.
The learning curve is short for an experienced surgeon, and the BoneScalpel is also a great teaching tool for our colleagues in training.