The utility of ultrasound for surgical spinal decompression

Alaqeel, Ahmed; Al-Shaar, Hussam Abou; Alaqeel, Alaa; Al‐Habib, Amro

doi:10.11152/mu.2013.2066.172.spd

Cited by 11 publications

(11 citation statements)

References 55 publications

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“…We predict our method could be directly used in veterinary medicine in the context of trials testing implantation of an OEC-hydrogel construct for SCI repair. Importantly, reports of intraoperative spinal cord ultrasound in humans 88,89 suggest these principles could be directly applied to human clinics.…”

Section: Resultsmentioning

confidence: 99%

Stiffness-matched biomaterial implants for cell delivery: clinical, intraoperative ultrasound elastography provides a ‘target’ stiffness for hydrogel synthesis in spinal cord injury

et al. 2020

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Safe hydrogel delivery requires stiffness-matching with host tissues to avoid iatrogenic damage and reduce inflammatory reactions. Hydrogel-encapsulated cell delivery is a promising combinatorial approach to spinal cord injury therapy, but a lack of in vivo clinical spinal cord injury stiffness measurements is a barrier to their use in clinics. We demonstrate that ultrasound elastography – a non-invasive, clinically established tool – can be used to measure spinal cord stiffness intraoperatively in canines with spontaneous spinal cord injury. In line with recent experimental reports, our data show that injured spinal cord has lower stiffness than uninjured cord. We show that the stiffness of hydrogels encapsulating a clinically relevant transplant population (olfactory ensheathing cells) can also be measured by ultrasound elastography, enabling synthesis of hydrogels with comparable stiffness to canine spinal cord injury. We therefore demonstrate proof-of-principle of a novel approach to stiffness-matching hydrogel-olfactory ensheathing cell implants to ‘real-life’ spinal cord injury values; an approach applicable to multiple biomaterial implants for regenerative therapies.

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Section: Resultsmentioning

confidence: 99%

Stiffness-matched biomaterial implants for cell delivery: clinical, intraoperative ultrasound elastography provides a ‘target’ stiffness for hydrogel synthesis in spinal cord injury

et al. 2020

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“…Surgeons use this technique to evaluate spinal decompression, lumbar disc degeneration, herniation, and muscle tears in children. It is limited by interoperator variability, artifacts, and elevated false-positive rates when assessing nerve root or spinal facet inflammation [ 10 ]. This method is not used commonly for evaluating complications, while abscesses or fluid collections are easily detected [ 11 ].…”

Section: Imaging Methodsmentioning

confidence: 99%

Imaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications

Corona-Cedillo

Saavedra-Navarrete

Espinoza-Garcia

et al. 2021

BioMed Research International

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Imaging of the postoperative spine requires the identification of several critical points by the radiologist to be written in the medical report: condition of the underlying cortical and cancellous bone, intervertebral disc, and musculoskeletal tissues; location and integrity of surgical implants; evaluation of the success of decompression procedures; delineation of fusion status; and identification of complications. This article presents a pictorial narrative review of the most common findings observed in noninstrumented and instrumented postoperative spines. Complications in the noninstrumented spine were grouped in early (hematomas, pseudomeningocele, and postoperative spine infection) and late findings (arachnoiditis, radiculitis, recurrent disc herniation, spinal stenosis, and textiloma). Complications in the instrumented spine were also sorted in early (hardware fractures) and late findings (adjacent segment disease, hardware loosening, and implant migration). This review also includes a short description of the most used diagnostic techniques in postoperative spine imaging: plain radiography, ultrasound (US), computed tomography (CT), magnetic resonance (MR), and nuclear medicine. Imaging of the postoperative spine remained a challenging task in the early identification of complications and abnormal healing process. It is crucial to consider the advantages and disadvantages of the imaging modalities to choose those that provide more accurate spinal status information during the follow-up. Our review is directed to all health professionals dealing with the assessment and care of the postoperative spine.

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“…While US has been widely used in spine surgery for several decades, 1 there is no previous report regarding its use to assess SCE. Furthermore, little is known about the mechanical properties of the spinal cord.…”

Section: Elasticity Assessments Of the Spinal Cordmentioning

confidence: 99%

In vivo assessment of spinal cord elasticity using shear wave ultrasound in dogs

Al‐Habib¹,

Albakr²,

Towim³

et al. 2018

Journal of Neurosurgery: Spine

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OBJECTIVEEvaluation of living tissue elasticity has wide applications in disease characterization and prognosis prediction. Few previous ex vivo attempts have been made to characterize spinal cord elasticity (SCE). Recently, tissue elasticity assessment has been clinically feasible using ultrasound shear wave elastography (SWE). The current study aims to characterize SCE in healthy dogs, in vivo, utilizing SWE, and to address SCE changes during compression.METHODSTen Greyhound dogs (mean age 14 months; mean weight 14.3 kg) were anesthetized and tracheally intubated, with hemodynamic and neurological monitoring. A 3-level, midcervical laminectomy was performed. SCE was assessed at baseline. Next, 8- and 13-mm balloon compressions were sequentially applied ventral to the spinal cord.RESULTSThe mean SCE was 18.5 ± 7 kPa. Elasticity of the central canal, pia mater, and dura mater were 21.7 ± 9.6 kPa, 26.1 ± 14.8 kPa, and 63.2 ± 11.5 kPa, respectively. As expected, the spinal cord demonstrated less elasticity than the dura mater (p < 0.0001) and pia mater (trend toward significance p = 0.08). Notably, the 13-mm balloon compression resulted in a stiffer spinal cord than at baseline (233 ± 73 kPa versus 18.5 ± 7 kPa, p < 0.0001) and 8-mm balloon compression (233 ± 73 kPa versus 185 ± 68 kPa, p < 0.048).CONCLUSIONSIn vivo SCE evaluation using SWE is feasible and comparable to earlier reports, as demonstrated by physical sectioning of the spinal cord. The compressed spinal cord is stiffer than a free spinal cord, with a linear increase in SCE with increasing mechanical compression. Knowledge of the biomechanical properties of the spinal cord including SCE has potential implications for disease management and prognosis.

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The utility of ultrasound for surgical spinal decompression

Cited by 11 publications

References 55 publications

Stiffness-matched biomaterial implants for cell delivery: clinical, intraoperative ultrasound elastography provides a ‘target’ stiffness for hydrogel synthesis in spinal cord injury

Stiffness-matched biomaterial implants for cell delivery: clinical, intraoperative ultrasound elastography provides a ‘target’ stiffness for hydrogel synthesis in spinal cord injury

Imaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications

In vivo assessment of spinal cord elasticity using shear wave ultrasound in dogs

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