[Experimental trial of intraoperative spinal ultrasound]

Dorsal operative stabilization of spinal fractures by internal fixation is an established means of treatment directed at releasing the extrinsic compression of the intraspinal contents caused by the fractured posterior surface of the vertebral body. There are few ways of assessing how successful the repositioning is intraoperatively. Intraoperative ultrasound with a special small transducer is possible, but it is difficult to reach the intraspinal area by this means, because it is surrounded by bones. A laminectomy would destabilize the injured vertebral column even further. By experiments performed on six human vertebral columns we show that it is possible to view the entire length of the fractured posterior surface by ultrasound. The beam has to be projected between the laminae vertebrae following a small laminotomy. Preliminary intraoperative experiences with eight patients confirm our experimental results. The intraoperative ultrasound results have been confirmed by preoperative and postoperative CT. We expect the necessity for laminectomy for examination of the posterior surface of the vertebral body to decline in frequency in the near future.