TY - JOUR
T1 - Intraoperative sonography in spinal dysraphism and syringohydromyelia
AU - Quencer, R. M.
AU - Montalvo, B. M.
AU - Naidich, T. P.
AU - Post, M. J.
AU - Green, B. A.
AU - Page, L. K.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1987
Y1 - 1987
N2 - The use of intraoperative sonography was analyzed in 24 patients with spinal dysraphism and syringohydromyelia in order to determine the role of real-time sonography in the surgical management of these patients. Specific diagnoses included tethered cord (nine), syringohydromyelia (seven), congenital tumor unassociated with a tethered cord (four), diastematomyelia (three), and occult sacral meningocele (one). Intraoperative sonography determined the exact relationship of congenital tumors to the cord before opening the dura, which allowed a more precise approach to the mass. Intraoperative sonography identified the lower end of the syrinx cavities, which allowed optimal catheter placement. Fibroglial scar tissue, which may compartmentalize these syrinx cavities, was clearly shown, and the efficacy of shunt catheter placement was immediately determined. In diastematomyelia, intraoperative sonography identified the relationship of the hemicords to bony, cartilaginous, and/or fibrous septa and demonstrated the effect on the tethered hemicords of (1) removing these septa and (2) constructing a single dural sac from the two dural sacs that had enclosed the hemicords. Since significant surgical decisions are based on these sonographic observations, the authors urge widespread use of intraoperative sonography in patients with spinal dysraphism and syringohydromyelia.
AB - The use of intraoperative sonography was analyzed in 24 patients with spinal dysraphism and syringohydromyelia in order to determine the role of real-time sonography in the surgical management of these patients. Specific diagnoses included tethered cord (nine), syringohydromyelia (seven), congenital tumor unassociated with a tethered cord (four), diastematomyelia (three), and occult sacral meningocele (one). Intraoperative sonography determined the exact relationship of congenital tumors to the cord before opening the dura, which allowed a more precise approach to the mass. Intraoperative sonography identified the lower end of the syrinx cavities, which allowed optimal catheter placement. Fibroglial scar tissue, which may compartmentalize these syrinx cavities, was clearly shown, and the efficacy of shunt catheter placement was immediately determined. In diastematomyelia, intraoperative sonography identified the relationship of the hemicords to bony, cartilaginous, and/or fibrous septa and demonstrated the effect on the tethered hemicords of (1) removing these septa and (2) constructing a single dural sac from the two dural sacs that had enclosed the hemicords. Since significant surgical decisions are based on these sonographic observations, the authors urge widespread use of intraoperative sonography in patients with spinal dysraphism and syringohydromyelia.
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U2 - 10.2214/ajr.148.5.1005
DO - 10.2214/ajr.148.5.1005
M3 - Article
C2 - 3554915
AN - SCOPUS:0023247130
VL - 148
SP - 1005
EP - 1013
JO - AJR. American journal of roentgenology
JF - AJR. American journal of roentgenology
SN - 0361-803X
IS - 5
ER -