Background: Ultrasound has been used as an intraoperative imaging option for spine surgery in 1982 and provides benefits as a great imaging modality for assessing soft tissue pathologies in real-time. Along with the development of technology and the presence of advanced imaging modalities, the role of ultrasound is often forgotten. In Indonesia, the role of intraoperative ultrasound has not become a routine modality for spinal tumor surgery despite its advantages and versatility. This study aimed to determine the role of intraoperative ultrasound for intradural spinal tumor surgery and to what extent the intraoperative ultrasound can be utilized based on our experience.
Methods: Two cases of intradural spinal tumors with different pathologies were presented. The initial diagnosis was made through contrast-enhanced magnetic resonance imaging scans. Intraoperative ultrasound was used to show the tumor in a sagittal fashion on three occasions, which were pre-removal, removal, and post-removal phase.
Results: We found intraoperative ultrasound to be a great and versatile modality in spine surgery, especially for intradural spinal tumors. This modality can be used for both total and hemilaminectomy and for both intra- and extramedullary pathology. Real-time evaluation can be performed quickly, radiation-free, cost-effective, and sensitive in assessing soft tissue.
Conclusion: Intraoperative ultrasound is a versatile modality for intradural spinal tumor surgery. The use of this modality needs to be introduced and taught in teaching programs and should become a routine modality for spinal tumor surgery, especially in developing countries where advanced intraoperative imaging modalities are not yet available.
Keywords: intraoperative ultrasound, spine surgery, spine tumor, ultrasonography