The Use of Intraoperative Ultrasonography in Intradural Spinal Tumor Surgery

To review our experience gained from the use of intraoperative ultrasonography (IOUSG) in intradural spinal tumor surgery.

IOUSG was used during surgery of 69 intradural spinal tumors, operated on between 2012 and 2016. A 5-8 MHz probe of IOUSG was used, before and after durotomy to perform the exact durotomy and myelotomy, and after tumor resection, to detect a residual tumor. A retrospective review of parameters including demographic data, localization and histopathology of the tumour, IOUSG findings, and the amount of tumor resection was made.

In a total of 69 intradural spinal tumors (42 extramedullary, and 27 intramedullary tumors) IOUSG was used during surgery. Total excision was performed in 68 cases, and subtotal excision in one case. Pre-durotomy IOUSG showed sufficient laminectomy in 62 cases. In 7 cases, as the IOUSG failed to show all borders of the tumor, laminectomy was extended.

IOUSG is an important tool, which contributes to intradural spine surgery. This modality shows the tumor appearance before durotomy, and is therefore helpful in deciding the amount of laminectomy and duratomy in addition to the exact location of myelotomy. It also provides the surgeon with information about residual tumor after excision, thereby increasing the safety and success of the surgical procedure.