Intraoperative Ultrasound Guided Spinal Tumor Resection

Objective: The objective was to assess the efficacy of intraoperative ultrasound in spinal intradural space occupying lesion. Methods we prospectively performed intraoperative ultrasound in 87 patients of spinal intradural space occupying lesion admitted at our university hospital. Intraoperative ultrasound with SonoSite, 180 plus hand carried ultrasound system with c11/7-4 Mhz curved array transducer probe was done in all cases. Extradural tumors, abcess,metastasis have been excluded from this study. A preoperative Magnetic resonance imaging was preformed in all patients. Preoperative and postoperative neurological function was assessed. Observations: Intraoperative ultrasound examination is excellent in localizing intradural space occupying lesions. Intraoperative ultrasound helps in planning the durotomy. In cases of small spinal tumors especially intramedullary tumors intraoperative ultrasound helps in pinpointing the location of tumor beneath the dura. Laminectomy or laminotomy can be extended if necessary according to size and location identified with repeated peroperative ultrasonic examination. Intraoperative ultrasound helps in delineating the completeness of resection. Residual tumor left if any was excised. Conclusion Intraopeative ultrasound is portable, does not require any specialized setup, provides real time images, cost effective, can be repeated as and when required during the procedure with minimum scanning time, and ensures patient and operator safety.