2001 年 14 巻 3-4 号 p. 100-104
The authors describe the use of Intraoperative ultrasonography during anterior keyhole surgery without fusion in 165 patients with cervical spondylotic myelopathy. They comprised of 97 men and 68 women, aged 21 to 86. Intraoperative ultrasound demonstrated movements of the spinal cord at the cardiac rate, and delineated the configuration of the cord. The reference endpoint ndpoint for decompression to be satisfactory was (1) clear sagittal imaging of sufficient pulsation of the cord and (2) good axial configuration of the cord. Levels of decompression included 60 cases of one level decompression, 63 cases of two levels, 40 of three levels, and 2 of four levels decompression. The overall recovery rate indicated that 74 cases in “excellent” (45%), 64 in “effective”, 17 in “improved” (10%), 9 in “unchanged” (5.4%), 1 in “worse” (0.6%) . The excellent, effective, and improved results was obtained in the cases in which good pulsation was observed in Intraoperative ultrasonography. In the cases with unchanged and worse results, good pulsation was observed in 7 cases. In our study, the intraoperative ultrasonography was not used as a predictor of the postoperative improvement but as an indicator for Intraoperative good decompression. The satisfactory surgical results was obtained with acceptable morbidity. The real-time ultrasonography is more simple, no time-consuming, and low-cost examination, and is proved to be quite versatile and useful for Intraoperative monitoring of good cervical decompression.