# Intraoperative and Postoperative Ultrasonographic Spinal Cord Evaluation of Cervical Double-Door Laminoplasty

## TL;DR

This study shows how a modified surgical technique allows for better ultrasound evaluation of the spinal cord during and after cervical laminoplasty.

## Contribution

A modified double-door laminoplasty technique is introduced to enable detailed ultrasonographic spinal cord evaluation.

## Key findings

- Intraoperative and postoperative spinal cord decompression was confirmed in all 11 patients.
- Ultrasound attenuation was reduced, allowing for clearer visualization of the spinal cord.
- Ultrasound-based evaluations provided new insights into spinal cord wave patterns.

## Abstract

Background: Ultrasonography is a useful tool for the localization, morphology, and characterization of lesions and is increasingly being applied to spinal cord evaluation in cervical spine diseases. However, in conventional cervical laminoplasty, detailed evaluation is difficult because of ultrasound attenuation. Therefore, the purpose of this study was to perform a cervical laminoplasty using a modified surgical technique and evaluate the spinal cord.

Methods: The spinal cord was evaluated intraoperatively and one week postoperatively in 11 patients with cervical compressive myelopathy. Double-door laminoplasty was selected as the surgical method, and the shape and placement of the bone graft between the expanded laminas were devised to reduce ultrasonic attenuation, such that there was a large space in which the dura mater was visible.

Results: Intraoperative and postoperative spinal cord decompression, claudication, and pulsation were confirmed in all cases. A more precise diagnosis was possible using ultrasound attenuation using the grafted bone between the laminas as an indicator.

Conclusion: Intraoperative and postoperative spinal cord decompression status and wave patterns of modified cervical double-door laminoplasty can be evaluated using ultrasonography. Ultrasound-based evaluations of the spinal cord may provide new insights.