Minimizing Invasiveness in Neurosurgical Osteotomies: A Comparative Histomorphometric Study of Piezoelectric Craniotomy versus High-Speed Drill

Piezoelectric bone cutting has gained popularity in neurosurgical osteotomies due to perceived lower trauma compared to rotary instruments. However, histological confirmation of its decreased aggressiveness is lacking, hindering conclusive proof. This study compares the bony and neuro-meningeal inva...

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Bibliographic Details
Published in:World neurosurgery 2024-11, Vol.191, p.e160-e166
Main Authors: Luzzi, Sabino, Crovace, Antonio, Carnevale, Sergio, Lacitignola, Luca, Staffieri, Francesco, Sfondrini, Domenico, Ordóñez-Rubiano, Edgar G., Crovace, Alberto Maria
Format: Article
Language:English
Subjects:
Animals
Bone healing
Craniotomy - instrumentation
Craniotomy - methods
Gliosis
High-speed drills
Histomorphometric study
Neurosurgical osteotomies
Neurosurgical Procedures - instrumentation
Neurosurgical Procedures - methods
Osteoblasts - pathology
Osteotomy - instrumentation
Osteotomy - methods
Piezoelectric craniotomy
Piezosurgery - instrumentation
Piezosurgery - methods
Sheep
Thermal damage
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Summary:Piezoelectric bone cutting has gained popularity in neurosurgical osteotomies due to perceived lower trauma compared to rotary instruments. However, histological confirmation of its decreased aggressiveness is lacking, hindering conclusive proof. This study compares the bony and neuro-meningeal invasiveness of piezoelectric craniotomy with high-speed drill techniques. Histological data from 21 sheep undergoing piezoelectric craniotomy and 19 sheep subjected to high-speed electric drill craniotomy were compared. Piezoelectric craniotomy utilized a 0.35 mm micro saw titanium nitride coated. Outcome parameters included the detection of the “smear layer,” average osteoblast count per high-power field, and residual bone matrix for bony invasiveness assessment. Parameters for meningeal and brain parenchymal invasiveness included pachymeningeal and leptomeningeal injury, gliosis, and histiocytic infiltration. Statistical significance was determined at P < 0.05. Results showed the Piezo group had fewer frequent smear layers (P
ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2024.08.088