Ultrasonic Bone Scalpel in Anterior Cervical Discectomy and Fusion Enhances Outcomes and Foraminal Decompression in Cervical Radiculopathy: A Retrospective Cohort Study

This study compared the safety and efficacy of ultrasonic bone scalpel-assisted direct decompression versus conventional direct decompression (using high-speed drills and Kerrison rongeurs) in anterior cervical discectomy and fusion (ACDF) for cervical radiculopathy with foraminal bone stenosis. This retrospective cohort study included 94 patients who underwent cervical foraminal stenosis surgery from 2019 to 2022. Group A (n=48) received traditional direct decompression using a high-speed drill and Kerrison rongeur, while Group B (n=46) underwent direct decompression using a combination of drilling and ultrasonic bone scalpel. Clinical outcomes were assessed using Visual Analog Scale (VAS) for pain, Neck Disability Index (NDI) for functional disability, and smallest oblique sagittal area (SOSA) of the neural foramen on CT scans to evaluate foraminal enlargement. Patients in Group B demonstrated significantly greater improvements in VAS and NDI scores (p<0.01), with a larger mean SOSA (73.85 mm² vs 50.00 mm²) compared to Group A. Additionally, Group B showed a reduction in blood loss and shorter operative time. No significant differences in complication rates, including dural tears or nerve root injuries, were found between the two groups. The ultrasonic bone scalpel-assisted decompression technique offers significant advantages over traditional methods in terms of surgical outcomes, including better pain relief, functional recovery, and foraminal enlargement, while maintaining comparable safety profiles.