title: Using Intraoperative Ultrasonography for Spinal Cord Tumor Surgery.
abstract: BACKGROUND
  Our aim was to evaluate the usefulness of modern intraoperative ultrasonography (iUS) in the resection of a wide variety of spinal intradural pathologic entities.
  
  
  METHODS
  We evaluated patients with spinal cord disease treated between January 2006 and September 2015. Intraoperative standard B-mode images were acquired using a 3.5-MHz to 12-MHz ultrasonographic probes (linear and curvilinear) on various ultrasound machines. The benefits and disadvantages of iUS were assessed for each case.
  
  
  RESULTS
  A total number of 158 intradural spinal lesions were operated on using iUS. Of these, 107 lesions (68%) were intradural extramedullary and 51 (32%) were intramedullary. All lesions were clearly visible using the ultrasound probe. The high-frequency linear probes (10-12 MHz) provided a better image quality compared with lower-frequency probes. Color and power-angiography modes were helpful in assessing the vascularization of the tumors and location of the major vessels in the vascular lesions.
  
  
  CONCLUSIONS
  We document how iUS was used to facilitate safe and efficient spinal tumor resection at each stage of the operation. iUS was beneficial in confirmation of tumor location and extension, planning myelotomy, and estimation of degree of resection of the intramedullary tumors. It was particularly helpful in guiding the approach in redo surgeries for recurrent spinal cord tumors.
  
  
  CONCLUSIONS
  iUS has a fast learning curve and offers additional intraoperative information that can help improve surgical accuracy and therefore may reduce procedure-related morbidity.
authors.affiliation: Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield University, Sheffield, United Kingdom. Electronic address: marcel.ivanov@nhs.net.
authors.forename: Marcel
authors.initials: M
authors.lastname: Ivanov
authors.affiliation: Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield University, Sheffield, United Kingdom.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Budu
authors.affiliation: Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield University, Sheffield, United Kingdom.
authors.forename: Hugh
authors.initials: H
authors.lastname: Sims-Williams
authors.affiliation: Department of Neurosurgery, "Gr T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Ion
authors.initials: I
authors.lastname: Poeata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D014463:Ultrasonography; D055815:Young Adult
keywords: Intradural spinal tumors; Intramedullary tumors; Intraoperative ultrasound; Spinal cord tumor