Intraoperative Ultrasonography as a Reliable Tool to Improve Canal Decompression in Vertebral Tumor Surgery

Ultrasound is nowadays a widely available tool at most surgical centers. Its use during surgery has been advocated for decades, but only recently have the appliances got to the proper size and speed so that a neurosurgeon may use it as real-time guidance during neurological procedures. At spine surgery, specially when decompression anterior to the dural sac is warranted, direct vision may be impaired. In such instances, the careful choice of probes and adequate imaging allow the surgeon to have a unique view in order to access anatomical landmarks, vascular changes and to guide the procedure overall. Two patients harboring intravertebral tumors with spine compression are presented. In both cases, intraoperative ultrasound was used. Those situations in which intraoperative ultrasound was essential to achieve successful decompression with no worsening of neurological condition illustrates the benefits of real-time imaging only that tool would deliver. In conclusion, intraoperative ultrasound is a reliable and helpful tool for spine surgery. It has the potential to add safety and efficacy for the procedures, specially to those in which the anterior spinal canal and dural sac is to be manipulated.