Ultrasound imaging of the spinal cord via the esophagus in conscious patients: Initial experience

Abstract

At present, computed tomography, nuclear magnetic resonance imaging, and myelography are the diagnostic methods of choice for the morphological evaluation of the spine. Ultrasound cannot penetrate the bony posterior arch of the vertebral column and can, therefore, be used only in patients with a spine bifida or after surgical laminectomy.1'2 Recently, an ultrasound image of the spinal cord via the esophagus was demonstrated for the first time using a variant technology based on transesophageal echocardiograThe sonographic examination of the heart through the esophagus is a widely accepted diagnostic and can be applied in conscious patients with only minor discomfort and with almost noIn this study we report on our initial experience with transesophageal ultrasound imaging of the spinal cord. PATIENTS AND METHODS PatientsA normal spinal cord was imaged in 50 patients undergoing transesophageal echocardiography. Five patients with a syringohydromyelia and 1 patient with von Recklinghausen neurofibromatosis, all previously diagnosed by CT and magnetic resonance imaging, were studied by transesophageal ultrasonography. the denticulate ligaments are seen as strong echogenic structures.

Estudio Ultrasonográfico de las Estructuras Nerviosas del Canal Vertebral a Nivel de la Articulación Atlantooccipital en Caninos Adultos

“…El espacio subaracnoídeo dorsal y ventral en ambos grupos de animales fue observado como una zona anecoica entre la capa compuesta por la duramadre y aracnoides y la superficie de la médula espinal (Fig. 1), debido a la presencia de líquido cefalorraquídeo (LCR), lo que coincide con lo descrito en estudios realizados en caninos (Finn-Bodner et al;Hudson 1995 y Jones), así como también en estudios realizados en humanos (Kawahara et al, 1987;Rubin et al;Mugge et al) y equinos (Gollob et al; Audigié et al).…”

“…espinal a través de la incompleta osificación del arco posterior de la columna vertebral (Raghavendra et al, 1983;Rubin et al, 1988;Brezner & Kay, 1999;Dick et al, 2002;Simanovsky et al, 2004). En adultos, se utiliza en pacientes con arcos vertebrales incompletos, como en el caso de la espina bífida, o después de efectuar una laminectomía (Rubin et al, 1988, Mugge et al, 1991. La ultrasonografía intraquirúrgica en humanos ha sido descrita para evaluar patologías de la médula espinal tales como tumores, siringomelia, quistes, traumas, mielomalacia y hernias de discos intervertebrales (Mantalvo & Quencer, 1986;Mantalvo et al, 1990;Mirvis & Geisler 1990;Matsuzaki et al, 1992;Mimatsu et al, 1992;Maiuri et al, 1997;Regelsberger et al, 2005).…”

Utility of transesophageal echocardiography in identifying spinal canal structures and epidural catheter position: a prospective observational study of intraoperative hemodynamics and postoperative analgesia

“…They reported successful imaging in 100% of cases, identifying 7.5 ± 2.3 spinal segments in the thoracic region. Mugge et al 19 also reported successful imaging of at least two spinal segments in 100% of cases, identifying three to five segments in 75% and more than five segments in 25% of cases. Ueda et al 12 reported visualizing spinal canal structures in all of their 12 pediatric cases.…”

Pulsatile spinal cord surrogate for intradural neuromodulation studies

“…In an effort to add a measure of physiological fidelity to this model, we have recently conceived and implemented a means for replicating in the surrogate the very low-amplitude, cardiac-driven pulsations that are present in the spinal cord (see, for example, Mügge et al [3]). Quantitative measurements of the amplitude of these pulsations have been made by Matsuzaki et al [4], who found that in canines the cyclical change in mean radius of the spinal cord, Δr, is on the order of 100 μm.…”