Ultrasound Guidance for Full Endoscopic Spinal Surgery: A Technical Note

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Medical Imaging

Background:

• Intraoperative ultrasound (IOU) is a valuable tool in spinal surgery.
• Full-endoscopic spine surgery (FESS) offers minimally invasive approaches.
• Integrating IOU into FESS enhances surgical precision and safety.

Purpose of the Study:

• To detail the application techniques of IOU in cervical, thoracic, and lumbar FESS.
• To provide guidance for surgeons mastering IOU in endoscopic spine procedures.

Main Methods:

• Cervical FESS: Localizing C6-C7, identifying anatomical landmarks for anterior/posterior approaches using IOU.
• Thoracic FESS: Rib counting for level localization, guiding endoscope to neural foramen via IOU.
• Lumbar FESS: Counting interlaminar windows from sacrum for level identification, advancing endoscope to neural foramen using IOU.

Main Results:

• IOU facilitates accurate surgical level localization in FESS.
• IOU-guided endoscopic sheath advancement prevents intraoperative complications.
• The use of IOU in FESS shows potential for reduced radiation exposure and decreased operative times.

Conclusions:

• IOU techniques are effectively applied in cervical, thoracic, and lumbar FESS.
• Mastery of IOU enhances the safety and efficiency of endoscopic spine surgery.
• This study aims to assist physicians in adopting IOU for FESS procedures.