Our Experience with the Use of a Pneumatic Kerrison Rongeur in Spinal Surgery: A Retrospective Study

Objectives: The Pneumatic Kerrison Rongeur (PKR) was introduced to overcome challenges associated with classical Kerrison Rongeurs (KRs), such as surgeon fatigue, limited dexterity, and potential tissue damage. This study aimed to evaluate the efficacy and advantages of the PKR in neurosurgical procedures compared with the classical KR.
Methods: Surgical outcomes, including operation time, blood loss, incision length, and postoperative pain scores, were assessed in groups using the PKR versus the classical KR.
Results: Surgeries performed using the PKR were associated with shorter operation times, reduced blood loss, and shorter incision lengths. No significant difference was found in preoperative or postoperative pain scores between the two groups. However, changes in Visual Analog Scale (VAS) scores on the first postoperative day were significant in both groups. Notably, the PKR provides enhanced dexterity, allowing surgeons to use both hands regardless of hand dominance. This increased flexibility may account for the shorter incision lengths observed. Despite its benefits, hesitancy to adopt the PKR in certain regions was observed, primarily due to concerns about uncontrolled biting and potential neural injury.
Conclusion: The Pneumatic Kerrison Rongeur offers distinct advantages over the classical KR, particularly in reducing operation time, blood loss, and incision size. These improvements may potentially reduce risks and complications, especially in elderly patients undergoing bilateral microdecompression for spinal canal stenosis.

Keywords: Kerrison rongeur, pneumatic Kerrison rongeur, spinal stenosis, surgical instruments