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Updated: Feb 25, 2026

Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Sonographic spinal imaging of normal anatomy, pathology and magnetic growing rods in children
Arthur B Meyers1, Tushar Chandra2, Monica Epelman2
1Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, 13535 Nemours Parkway, Orlando, FL, 32827, USA. arthurbmeyers@yahoo.com.
Insights
Ultrasound is a safe, first-line imaging tool for pediatric spinal evaluation, especially in infants. It assesses normal anatomy, pathology, and growing spinal rods without radiation.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Ultrasound Technology
Background:
- Sonography is a preferred initial imaging modality in pediatric patients due to its safety and accessibility.
- Infants' developing spinal anatomy offers a unique window for detailed spinal canal imaging.
- Conventional imaging methods may involve ionizing radiation or sedation, posing risks to children.
Purpose of the Study:
- To review the clinical indications, techniques, and findings for lumbosacral spine ultrasound in neonates and infants.
- To describe the ultrasound assessment of magnetically controlled growing spinal rods.
- To highlight ultrasound's utility in evaluating spinal hardware without ionizing radiation.
Main Methods:
- Review of clinical indications for pediatric spinal ultrasound.
- Description of sonographic techniques for neonatal and infant lumbosacral spine imaging.
- Explanation of ultrasound protocol for assessing growing spinal rods.
Main Results:
- Ultrasound provides detailed visualization of the spinal canal and contents in young infants.
- Sonography effectively evaluates normal anatomy, congenital abnormalities, and pathology of the pediatric spine.
- Ultrasound assessment of growing spinal rods allows for accurate measurement of distraction without radiation exposure.
Conclusions:
- Ultrasound is a valuable, radiation-free tool for evaluating the pediatric lumbosacral spine and its contents.
- Sonography facilitates the monitoring of spinal growth hardware, aiding orthopedic and radiologic management.
- The technique offers a safe and effective alternative to ionizing radiation-based imaging in pediatric spinal assessment.
Abstract:
The wide availability of ultrasound, along with its lack of ionizing radiation burden and need for sedation for most exams, often make sonography the first line in the imaging evaluation of children. The developing osseous anatomy of the spine in young infants provides a distinct window allowing for a detailed depiction of the spinal canal and its contents, which is not present in older children or adults. Here we review the clinical indications, sonographic technique, normal anatomy and pathology for imaging the lumbosacral spine in neonates and young infants. Additionally, we review the procedure for ultrasound assessment of the lengthening of magnetically controlled growing spinal rods, which allows orthopedists and radiologists to evaluate the effectiveness of distraction procedures of this hardware without the use of ionizing radiation.
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