Using Intraoperative Ultrasonography for Spinal Cord Tumor Surgery

Area of Science:

• Neurosurgery
• Medical Imaging
• Oncology

Background:

• Spinal intradural pathologies present unique surgical challenges.
• Accurate intraoperative localization and assessment are crucial for effective resection.

Purpose of the Study:

• To evaluate the utility of modern intraoperative ultrasonography (iUS) in resecting diverse spinal intradural lesions.
• To assess the benefits and limitations of iUS in spinal surgery.

Main Methods:

• Retrospective analysis of 158 patients undergoing spinal intradural lesion resection between January 2006 and September 2015.
• Utilization of intraoperative standard B-mode ultrasonography with 3.5-MHz to 12-MHz probes (linear and curvilinear).
• Assessment of iUS benefits and disadvantages for each case.

Main Results:

• iUS clearly visualized all 158 intradural spinal lesions (107 extramedullary, 51 intramedullary).
• High-frequency linear probes (10-12 MHz) offered superior image quality.
• Color and power Doppler modes aided in vascular assessment and identification of major vessels.

Conclusions:

• iUS facilitates safe and efficient spinal tumor resection, aiding in tumor localization, extension assessment, and myelotomy planning.
• It is particularly valuable for reoperations on recurrent spinal cord tumors.
• iUS has a rapid learning curve and improves surgical accuracy, potentially reducing morbidity.