Enhanced Safety of Pedicle Subtraction Osteotomy Using Intraoperative Ultrasound

Chryssikos, Timothy; Wessell, Aaron; Pratt, Nathan; Cannarsa, Gregory; Sharma, Ashish; Olexa, Joshua; Han, Nathan; Schwartzbauer, Gary; Sansur, Charles A.; Crandall, Kenneth M.

doi:10.1016/j.wneu.2021.05.120

Cited by 3 publications

(5 citation statements)

References 61 publications

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“…In this position, the surgeon can operate proficiently and obtain a very wide field of vision during decompression. According to the literature, the prone position should be used for all patients undergoing spine surgery guided by intraoperative ultrasound 7 . In this position, the neural elements are located at the bottom of the surgical field.…”

Section: Discussionmentioning

confidence: 99%

“…According to the literature, the prone position should be used for all patients undergoing spine surgery guided by intraoperative ultrasound. 7 In this position, the neural elements are located at the bottom of the surgical field. After normal saline is added, the liquid just covers the nerve structure, so that the surgeon can add normal saline directly into the surgical cavity for ultrasonic coupling to perform the intraoperative ultrasound examination.…”

Section: Technology Of This Studymentioning

confidence: 99%

“…6 The ultrasound technique has been used in spinal surgery with the patient in the prone position. 7 Water is used as a sound-transmitting medium to detect the neural elements during surgery. In the prone position, the neural structures are at the bottom of the surgical field.…”

Section: Introductionmentioning

confidence: 99%

“…The ultrasound technique has been used in spinal surgery with the patient in the prone position 7 . Water is used as a sound‐transmitting medium to detect the neural elements during surgery.…”

Section: Introductionmentioning

confidence: 99%

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How to Apply Intraoperative Ultrasound when Spinal Trauma Surgery Is Performed in the Lateral Decubitus Position?

Li,

Liu,

Gao

et al. 2023

Orthopaedic Surgery

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ObjectiveAt present, intraoperative ultrasound was widely used in spinal surgery. But there have been no reports on the use of intraoperative ultrasound in lateral decubitus position spinal surgery. The authors’ research objective was to describe the applications of intraoperative ultrasound in spinal trauma surgery when performed in the lateral decubitus position.MethodsSix patients with polytrauma who underwent surgery for spinal trauma between June 2020 and March 2022 and could not be operated on using a posterior approach in the prone position. All six patients underwent surgery in the lateral decubitus position. During surgery, a capsular bag had been designed and surgical field can be filled with normal saline for acoustic coupling, and then ultrasound was used to observe and guide decompression, and assess injuries of the neural elements such as the spinal cord. The data of preoperative and postoperative (12 months) American Spinal Injury Association impairment scale (AIS), follow‐up time, operation time, blood loss, ultrasound signal change of spinal cord, ultrasound guide decompression, internal fixation (12 months), and fracture healing(12 months) were collected.ResultsThe study included four males and two females whose ages ranged from 19 to 56 years old (41.5 ± 13.06 years old). Follow‐up times ranged from 12 to 20 months (14.33 ± 2.75 months). The operation times ranged from 195 to 248 mins (222.16 ± 16.86 mins). The estimated volume of blood loss ranged from 280 to 450 mL (383.33 ± 55.58 mL). The six cases’ AIS (preoperative vs. postoperative) were A versus A, C versus D, A versus B, B versus B, B versus C, and B versus C. Intraoperative ultrasound was performed successfully in all patients using our designed method. Intraoperative ultrasound observation revealed varying degrees of changes in spinal cord echo in all patients. Intraoperative ultrasound provided excellent assistance in spinal cord decompression during surgery. The surgery was completed successfully with no surgery‐related complications till the last follow‐up. At the time of last follow‐up (median time of 12 months) satisfactory fracture reduction and good internal fixation was confirmed on postoperative computed tomography scans and radiographs.ConclusionsThe authors represented the technology of intraoperative ultrasound in spinal trauma surgery when performed in the lateral decubitus position. This technology solves how to apply intraoperative ultrasound in lateral decubitus position.

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Section: Discussionmentioning

confidence: 99%

Section: Technology Of This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

How to Apply Intraoperative Ultrasound when Spinal Trauma Surgery Is Performed in the Lateral Decubitus Position?

Li,

Liu,

Gao

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…Ultrasound, on the other hand, is far less expensive and much more flexible, and several advantages provided by intraoperative ultrasound have been previously described in a variety of spine surgery settings. 10…”

mentioning

confidence: 99%