Intraoperative Ultrasound Monitoring in Anterior Dura Sac Decompression Through Posterior Approach for the Treatment of Thoracolumbar Fracture With Paralysis / 中华骨科杂志

ABSTRACT

Objective\ To observe the practicality of sonography for differentiating the compression factors and judging whether thorough decompression anterior to the dura sac has been obtained. Methods Posterior midline incision was used in a total of 16 cases. After the laminae were resected, normal saline was poured into the operation field, and ultrasound examination performed with a 5.0 MHz sectorscanner. Combined with preoperative imaging (CT or MRI),the compression factors were differentiated. The isolated tissue(bone or disc)pieces in spinal canal were removed first,then reduction of approximate and distal parts of the injuried spinal column was obtained with the help of the Dick devices. Posteriorly protruded bone mass was tumbled in carefully supervised with sonography. The sonographic criterion for thorough decompression consisted of the reappearance of the anterior subarachnoid and an even and smooth echo of posterior dura mater. Results\ The sonographic criterion for thorough decompression was achieved in all cases. No bone mass posterior displacement was observed on postoperative rontgenogram or CT examination. Partial or complete recovery of neural function was obtained in 13 cases. Conclusion\ All elements contributing to anterior dura sac compression can be readily recognized by sonography,which offers a reliable criterion for complete decompression.