A study using intraoperative sonography (IOS) was conducted for evaluating neural mobility in anterior cervical decompression surgery.Objectives:
To analyze decompression status and mobility of the spinal cord and the nerve root during anterior cervical decompression and to clarify its relevance to the postoperative neurological recovery.Summary of Background Data:
Several papers introduced the usefulness of IOS assessments; however, there have been no reports systematically evaluating the neural mobility in anterior cervical decompression surgery.Methods:
Eighty-four consecutive patients with compressive myelopathy who underwent anterior cervical decompression procedures were studied. The decompression status of the spinal cord was evaluated with IOS and classified into 3 grades according to the restoration pattern of the space ventral to the cord. Pulsatile motion of the spinal cord in cranio-caudal direction was named “sliding pulsation” and graded into 3 groups. The nerve root pulsation was also assessed using the IOS short-axis views. This study analyzed whether those neural mobility in anterior cervical decompression surgery had relevance to postoperative neurological recovery, which was assessed by the Japan Orthopaedic Association score.Results:
The mean recovery rate of the Japan Orthopaedic Association score was 59.1% in total. According to the decompression status in IOS, 67 patients who acquired space ventral to the spinal cord indicated 64.3% of the recovery rate which was significantly higher than 36.6% of the other patients on an average. As to the sliding pulsation of the cord, 10 patients who failed to show this particular motion indicated significantly lower recovery rate as 36.9%. In addition, 6 patients who did not exhibit nerve root pulsation indicated just 29.3% of recovery rate, and 4 of them failed to show the cord sliding motion.Conclusions:
Sonographic evaluation during anterior cervical decompression surgery provided very useful information of neural decompression status that had significant correlation with postoperative neurological recovery.