Neurosurgery, 2023 · DOI: 10.1227/neu.0000000000002207 · Published: February 1, 2023
This study compares intraoperative ultrasound (IOUS) to postoperative MRI and CT myelography in assessing spinal cord decompression after surgery for cervical spinal cord injury. The study found that IOUS can be a useful tool to supplement postoperative imaging. However, severe injuries may have swelling after surgery, affecting decompression. Patients with more severe injuries and larger lesions were more likely to have inadequate decompression on postoperative MRI/CT myelography despite initial IOUS assessment.
IOUS can be used as a real-time tool during surgery to assess the adequacy of spinal cord decompression, potentially leading to immediate adjustments in the surgical plan.
Preoperative IMLL can help predict the likelihood of inadequate decompression, even with IOUS guidance, prompting consideration of additional surgical interventions like duraplasty.
Postoperative MRI/CT myelography remains important for assessing spinal cord decompression, especially in severe injuries, as IOUS findings may not always reflect the final outcome due to postoperative swelling.