title: New heights in ultrasound: first report of spinal ultrasound from the international space station.
abstract: BACKGROUND
  Changes in the lumbar and sacral spine occur with exposure to microgravity in astronauts; monitoring these alterations without radiographic capabilities on the International Space Station (ISS) requires novel diagnostic solutions to be developed.
  
  
  OBJECTIVE
  We evaluated the ability of point-of-care ultrasound, performed by nonexpert-operator astronauts, to provide accurate anatomic information about the spine in long-duration crewmembers in space.
  
  
  METHODS
  Astronauts received brief ultrasound instruction on the ground and performed in-flight cervical and lumbosacral ultrasound examinations using just-in-time training and remote expert tele-ultrasound guidance. Ultrasound examinations on the ISS used a portable ultrasound device with real-time communication/guidance with ground experts in Mission Control.
  
  
  RESULTS
  The crewmembers were able to obtain diagnostic-quality examinations of the cervical and lumbar spine that would provide essential information about acute or chronic changes to the spine.
  
  
  CONCLUSIONS
  Spinal ultrasound provides essential anatomic information in the cervical and lumbosacral spine; this technique may be extensible to point-of-care situations in emergency departments or resource-challenged areas without direct access to additional radiologic capabilities.
authors.affiliation: National Aeronautics and Space Administration, Johnson Space Center, Houston, Texas.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Marshburn
authors.affiliation: Canadian Space Agency, John H. Chapman Space Centre, Saint Hubert, Quebec, Canada.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Hadfield
authors.affiliation: Wyle Science, Technology & Engineering Group, Houston, Texas.
authors.forename: Ashot E
authors.initials: AE
authors.lastname: Sargsyan
authors.affiliation: Wyle Science, Technology & Engineering Group, Houston, Texas.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Garcia
authors.affiliation: Wyle Science, Technology & Engineering Group, Houston, Texas.
authors.forename: Douglas
authors.initials: D
authors.lastname: Ebert
authors.affiliation: Department of Surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Dulchavsky
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D004505:Education, Nonprofessional; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D019114:Remote Consultation; D012447:Sacrum / Q000000981:diagnostic imaging*; D013026:Space Flight; D014463:Ultrasonography / Q000379:methods; D014893:Weightlessness / Q000009:adverse effects*
keywords: International Space Station; remote care; spine; telemedicine; ultrasound