Degreif J, Wenda K, Hüwel N, Ritter G
Klinik und Poliklinik für Unfallchirurgie, Johannes Gutenberg-Universität Mainz.
Unfallchirurg. 1993 Feb;96(2):88-92.
The question of whether fragments of the posterior vertebral surface have to be removed in every case remains to be answered. Nevertheless, in many cases it is important to establish the situation inside the spinal canal intraoperatively. To this end we have used intraoperative ultrasound in 21 cases. The results have always corresponded closely with the findings of preoperative and postoperative computed tomography. Under the influence of this method we have modified our operative procedure. The technique of intraoperative ultrasound and our current operative practice are described in the present paper. We use typical cases to show that intraoperative ultrasound of the spinal canal is a very useful technique for several reasons: Accurate depiction of the spinal canal is always possible without destabilizing the dorsal vertebral structures. The risks and disadvantages of intraoperative myelography are avoided. The method is easy and can be repeated as often as desired, an important advantage in checking the success of the removal of fragments and in reviewing the situation after transpedicular cancellous bone grafting.
是否在每种情况下都必须切除椎体后表面的碎片这一问题仍有待解答。然而,在许多情况下,术中确定椎管内的情况很重要。为此,我们在21例病例中使用了术中超声。结果总是与术前和术后计算机断层扫描的结果密切相符。在这种方法的影响下,我们修改了手术操作。本文描述了术中超声技术和我们目前的手术操作方法。我们用典型病例表明,椎管术中超声是一项非常有用的技术,原因如下:始终能够准确描绘椎管,而不会破坏背侧椎体结构的稳定性。避免了术中脊髓造影的风险和缺点。该方法简单,可以根据需要多次重复,这在检查碎片清除的成功情况以及评估经椎弓根松质骨移植后的情况方面是一个重要优势。