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Detection of Residual Disc Hernia Material and Confirmation of Nerve Root Decompression at Lumbar Disc Herniation Surgery by Intraoperative Ultrasound

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タイトル: Detection of Residual Disc Hernia Material and Confirmation of Nerve Root Decompression at Lumbar Disc Herniation Surgery by Intraoperative Ultrasound
著者: Aoyama, Takeshi 著作を一覧する
Hida, Kazutoshi 著作を一覧する
Akino, Minoru 著作を一覧する
Yano, Shunsuke 著作を一覧する
Iwasaki, Yoshinobu 著作を一覧する
キーワード: Echography
Intraoperative
Lumbar disc herniation
Ultrasonography
Ultrasound
発行日: 2009年 6月
出版者: Elsevier Inc.
誌名: Ultrasound in Medicine & Biology
巻: 35
号: 6
開始ページ: 920
終了ページ: 927
出版社 DOI: 10.1016/j.ultrasmedbio.2008.12.014
抄録: The aim of lumbar disc herniation surgery is the removal of herniated disc material (HDM) and complete decompression of the nerve root. As some patients present with residual HDM, we examined the ability of intraoperative ultrasound (IOUS) to detect this material. Between February 2006 and June 2007, we used IOUS in 30 patients undergoing surgery for lumbar disc herniation. They were 17 men and 13 women; their ages ranged from 22 to 63 years (mean 44.0). The level surgically addressed was L3/4 in 1-, L4/5 in 14-, and L5/S1 in 15 patients; they were operated in the prone position. After placing a 3-4 cm midline skin incision, partial hemi-semilaminotomy was performed. HDM was removed through a bone window; a surgical microscope was used during the operation. After removal was judged as adequate, IOUS was performed; 17 patients also underwent IOUS before removal of the herniated disc. For the acquisition of IOUS images we used LOGIQ 9 and 8c microconvex probes (GE Healthcare, USA). The normal anatomical structures were well-visualized. HDM was iso- to high-echoic compared to normal nerve tissue. In 3 of 17 patients the dural sac and nerve root could not be distinguished from HDM before removal although in all 30 the decompressed dural sac, intradural cauda equina, and nerve root were well visualized. We posit that the echogenicity of nerve tissue was raised due to compression, rendering it similar to that of the herniated disc. In 2 patient IOUS detected residual disc material; the surgical procedure was resumed and sufficient removal was accomplished. IOUS monitoring is safe, convenient and inexpensive. It is also highly useful for the detection of residual HDM and the confirmation of adequate nerve root decompression.
資料タイプ: article (author version)
URI: http://hdl.handle.net/2115/38757
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 青山 剛

 

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