The utility of intraoperative ultrasonography for spinal cord surgery

PLoS ONE, 2024 · DOI: https://doi.org/10.1371/journal.pone.0305694 · Published: July 10, 2024

Simple Explanation

Intraoperative ultrasonography (IOUS) is a real-time imaging technique that can be used during spinal cord surgery to help surgeons visualize the tumor's extent and location. IOUS can also help surgeons minimize damage to neural structures during surgery by providing a clear picture of the surgical field. Despite its benefits, IOUS is not yet widely used in spinal cord surgery. This study aims to discuss the advantages of utilizing IOUS in various spinal cord diseases and review related literature.

Study Duration

November 2021 to December 2023

Participants

43 patients undergoing spinal cord surgery

Evidence Level

Retrospective study

Key Findings

1
IOUS confirmed tumor extent and location before dura opening in 97.7% of patients, aiding in surgical planning and minimizing neural injury.
2
IOUS detected residual or hidden lesions in 7.0% of patients, allowing for additional tumor resection to achieve gross total resection.
3
In 7.0% of patients, IOUS confirmed no intradural lesions after removing extradural tumors, avoiding unnecessary dural incisions.

Research Summary

This study retrospectively reviewed 43 patients who underwent spinal cord surgery utilizing IOUS to evaluate its benefits. The study found that IOUS was helpful in confirming tumor extent and location, detecting residual lesions, and verifying the absence of hematoma post-tumor removal. The authors conclude that IOUS can be a valuable tool for spinal cord surgery in identifying the exact location of pathologic lesions, confirming the completeness of surgery, and minimizing the risk of neural and vascular injury in a real-time fashion.

Practical Implications

Improved Surgical Planning

IOUS provides real-time visualization of tumor location and extent, allowing surgeons to optimize surgical approaches and minimize neural damage.

Enhanced Resection Completeness

IOUS can detect residual or hidden lesions, enabling surgeons to perform additional resection and achieve gross total resection.

Reduced Unnecessary Procedures

IOUS can confirm the absence of intradural lesions, avoiding unnecessary dural incisions and reducing the risk of complications.

Study Limitations

1
Single institution study with a relatively small number of subjects.
2
Lack of comparison between patients who used IOUS versus those who did not use IOUS.
3
Study did not evaluate the delay in surgical time and the increase in medical costs associated with the use of IOUS.

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