Intraoperative Sonographie des Myelons

AIM Our intention was to examine the value of ultrasonography in the case of spinal stenosis caused by bony fragments or a tumour. Pre- and postoperative computed tomographies were compared with intraoperative ultrasound images. METHOD Intraoperative sonography during spinal surgery was used after laminotomy or laminectomy in twenty patients with a stenosis of the spinal canal, caused by fragments or tumours. RESULTS The posterior vertebral wall as well as tumour-tissue and myelon can be well distinguished by sonography. The dural sheath remains sonographically visible as a white line between tumour-tissue and myelon even in the case of immense compression. Small bony fragments or herniated disc material are also visible in the spinal canal. Thin surgical instruments can be guided into their target region under ultrasonographic control. When the restored epidural space can be demonstrated sonographically, this proves complete decompression of the spinal cord. CONCLUSION Intraoperative ultrasound is an unrestricted repeatable real-time method for the surgeon to control the restoration and the width of the spinal canal. The extent of the operation depends on the results of the intraoperative sonography.