Percutaneous Ultrasonographic Evaluation of the Spinal Cord After Cervical Laminoplasty

Abstract

Prospective cohort study. To investigate the dynamic changes of cervical spinal cord with postural change after cervical laminoplasty by means of postoperative percutaneous ultrasonography. Many reports have been published about intraoperative ultrasonographic evaluation of the spinal cord. Few reports have described postoperative diagnostic ultrasonographic findings of the spinal cord after a previous laminectomy. To date, there are no studies that have examined the changes in pulsation pattern and intensity of the spinal cord at different body positions with percutaneous ultrasonography. Thirty-three patients after cervical laminoplasty were evaluated postoperatively by percutaneous ultrasonography of the cervical spinal cord. Ultrasonographic images were obtained from 5 different body positions sitting with neck neutral, sitting with neck flexion, sitting with neck extension, prone, and supine position. The pattern and intensity of cervical spinal cord pulsation and the anteroposterior position of the cervical spinal cord changed according to posture. Pulsation of the cervical spinal cord was more common in sitting position, whereas wave motion was more common in supine position.Supine, prone, sitting with neck extension, sitting with neck neutral, and sitting with neck flexion position were ranked in descending order of spinal cord pulsating intensity. Subarachnoidal space ventral to the cervical spinal cord was more likely to appear in the supine position. Assuming that good spinal cord pulsation represents good spinal circulation, these results suggest that the supine position will provide the most favorable condition for recovery of the cervical spinal cord.