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颈椎双开门椎板成形术术中及术后脊髓的超声评估

Intraoperative and Postoperative Ultrasonographic Spinal Cord Evaluation of Cervical Double-Door Laminoplasty.

作者信息

Matsuo Atsushi, Sato Kimiaki, Yokosuka Kimiaki, Fudo Takuma, Hiraoka Koji

机构信息

Department of Orthopaedics, Kurume University, Kurume, JPN.

出版信息

Cureus. 2024 May 29;16(5):e61283. doi: 10.7759/cureus.61283. eCollection 2024 May.

Abstract

BACKGROUND

Ultrasonography is a useful tool for the localization, morphology, and characterization of lesions and is increasingly being applied to spinal cord evaluation in cervical spine diseases. However, in conventional cervical laminoplasty, detailed evaluation is difficult because of ultrasound attenuation. Therefore, the purpose of this study was to perform a cervical laminoplasty using a modified surgical technique and evaluate the spinal cord.

METHODS

The spinal cord was evaluated intraoperatively and one week postoperatively in 11 patients with cervical compressive myelopathy. Double-door laminoplasty was selected as the surgical method, and the shape and placement of the bone graft between the expanded laminas were devised to reduce ultrasonic attenuation, such that there was a large space in which the dura mater was visible.

RESULTS

Intraoperative and postoperative spinal cord decompression, claudication, and pulsation were confirmed in all cases. A more precise diagnosis was possible using ultrasound attenuation using the grafted bone between the laminas as an indicator.

CONCLUSION

Intraoperative and postoperative spinal cord decompression status and wave patterns of modified cervical double-door laminoplasty can be evaluated using ultrasonography. Ultrasound-based evaluations of the spinal cord may provide new insights.

摘要

背景

超声检查是用于病变定位、形态学及特征描述的有用工具,并且越来越多地应用于颈椎疾病的脊髓评估。然而,在传统颈椎椎板成形术中,由于超声衰减,难以进行详细评估。因此,本研究的目的是采用改良手术技术进行颈椎椎板成形术并评估脊髓。

方法

对11例颈椎压迫性脊髓病患者在术中及术后1周进行脊髓评估。选择双开门椎板成形术作为手术方法,并设计扩大椎板间植骨的形状和位置以减少超声衰减,从而形成一个可看到硬脑膜的大空间。

结果

所有病例均证实术中及术后脊髓减压、跛行及搏动情况良好。以椎板间植骨的超声衰减为指标可进行更精确的诊断。

结论

改良颈椎双开门椎板成形术的术中及术后脊髓减压状态和波形可通过超声检查进行评估。基于超声的脊髓评估可能会提供新的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/478b/11211860/22939477ada9/cureus-0016-00000061283-i01.jpg

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