Real-time sonography during spinal surgery.

Real-time sonography was performed during spinal surgery in eight adult patients with seven different types of lesions. Cervical, thoracic, and lumbar lesions were included. All were examined prior to dural opening, using the saline-filled wound for water-path imaging. Five extramedullary masses and two intramedullary cavities were well delineated, allowing optimal surgical access to be determined at the moment of approach. Sonography also was abnormal in one case of diffuse spinal cord expansion, but no tissue sonographically distinguishable from spinal cord substance could be identified. Adequacy of surgical treatment was evaluated by repeat sonography before dural closure in one case of extramedullary mass and two cases of intramedullary cavities. Sonography is both reliable and beneficial during surgery for a variety of intraspinal lesions.