title: Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty.
abstract: METHODS
  Prospective cohort study.
  
  
  OBJECTIVE
  To investigate the dynamic changes of cervical spinal cord with postural change after cervical laminoplasty by means of postoperative percutaneous ultrasonography.
  
  
  BACKGROUND
  Many reports have been published about intraoperative ultrasonographic evaluation of the spinal cord. Few reports have described postoperative diagnostic ultrasonographic findings of the spinal cord after a previous laminectomy. To date, there are no studies that have examined the changes in pulsation pattern and intensity of the spinal cord at different body positions with percutaneous ultrasonography.
  
  
  METHODS
  Thirty-three patients after cervical laminoplasty were evaluated postoperatively by percutaneous ultrasonography of the cervical spinal cord. Ultrasonographic images were obtained from 5 different body positions sitting with neck neutral, sitting with neck flexion, sitting with neck extension, prone, and supine position.
  
  
  RESULTS
  The pattern and intensity of cervical spinal cord pulsation and the anteroposterior position of the cervical spinal cord changed according to posture. Pulsation of the cervical spinal cord was more common in sitting position, whereas wave motion was more common in supine position.Supine, prone, sitting with neck extension, sitting with neck neutral, and sitting with neck flexion position were ranked in descending order of spinal cord pulsating intensity. Subarachnoidal space ventral to the cervical spinal cord was more likely to appear in the supine position.
  
  
  CONCLUSIONS
  Assuming that good spinal cord pulsation represents good spinal circulation, these results suggest that the supine position will provide the most favorable condition for recovery of the cervical spinal cord.
authors.affiliation: *Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan; and †Department of Orthopaedic Surgery, Seihoku Chuo Hospital, Goshogawara, Aomori, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kowatari
authors.forename: Taisuke
authors.initials: T
authors.lastname: Nitobe
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ono
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Taito
authors.initials: T
authors.lastname: Itabashi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ishibashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography