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Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty: time-dependent changes

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Abstract

Purpose

The first purpose of this study is to confirm whether the spinal cord and the surrounding tissues can be visualized clearly after laminoplasty using percutaneous ultrasonography. And second purpose is to evaluate the changes in the status of the spinal cord over time.

Methods

Fifty patients who underwent cervical laminoplasty with suture anchors were evaluated using intraoperative ultrasonography and postoperative (1 week, 2 weeks, 3 months, 6 months, and 1 year) percutaneous ultrasonography. We classified the decompression status of the spinal cord into three grades and the pattern of the spinal cord pulsation into six categories. Clinical outcomes were evaluated using the Japanese Orthopaedic Association Score for cervical myelopathy, and the recovery rate was calculated.

Results

In all cases and all periods, we could observe the status of the spinal cord using percutaneous ultrasonography after cervical laminoplasty. The decompression status of the spinal cord improved until 3 months postoperatively, and the clinical outcomes improved up to 6 months postoperatively. Although the pulsation pattern of the spinal cord varied in each individual and in each period, spinal pulsation itself was observed in all cases and all periods, except one, when an epidural hematoma caused quadriplegia and a revision surgery was needed. Decompression status and pulsation pattern of the spinal cord were not associated with clinical outcomes as far as pulsation was observed.

Conclusions

Percutaneous ultrasonography was very useful method to evaluate the postoperative status of the spinal cord, particularly in the diagnosis of the postoperative epidural hematoma.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Osaka Medical College, 2-7, Daigakumachi, Takatsuki-shi, Osaka, 569-8686, Japan

    Yoshiharu Nakaya, Atsushi Nakano, Kenta Fujiwara, Takashi Fujishiro, Sachio Hayama, Toma Yano & Masashi Neo

Authors
  1. Yoshiharu Nakaya
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  2. Atsushi Nakano
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  3. Kenta Fujiwara
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  4. Takashi Fujishiro
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  5. Sachio Hayama
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  6. Toma Yano
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  7. Masashi Neo
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Corresponding author

Correspondence to Yoshiharu Nakaya.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethics review board of our institution; Osaka medical college (No. 2403).

Informed consent

For this type of study formal consent is not required according to the Japanese ethical guideline for clinical research. Instead, we provided the patients with the opportunity to opt out on website.

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Nakaya, Y., Nakano, A., Fujiwara, K. et al. Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty: time-dependent changes. Eur Spine J 27, 2763–2771 (2018). https://doi.org/10.1007/s00586-018-5752-4

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  • DOI: https://doi.org/10.1007/s00586-018-5752-4

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