A new technique for intraoperative visual monitoring during spinal surgery: angiofiber and endoscopic ultrasonography.
OBJECTIVE
This paper is focused on our clinical use of endoscopic ultrasonography (EUS) and angiofiber (AF) for spinal microsurgery.


METHODS
EUS and AF were used in seven operations for syringomyelia and spinal tumor. We used EUS for extradural observation, and AF for extra and intra-dural, subarachnoid and intraluminal visual evaluation of the lesions.


RESULTS
EUS images of the spinal cord, roots and lesions were clear, providing precise evaluation of the lesion and the course of the shunt tube in real time during surgery. AF could provide clear vision of the syrinx lumen or subarachnoid space. Because these fine instruments could be advanced under the unresected laminae, sonographic and endoscopic images were obtained from beyond the extent of laminotomy, where the microscope could not reach.


CONCLUSIONS
Combined together, EUS and AF contributed to accurate and safe spinal surgery while minimising the laminotomy.
Hara
Y
Y
Department of Neurosurgery, Kobe University School of Medicine, Kobe, Japan. yyhr@med.kobe-u.ac.jp
Tamaki
N
N
Nakamura
M
M
Nagashima
T
T
Yamashita
H
H
Takaishi
Y
Y
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D013131:Spine / Q000601:surgery*