Avaliação ultrassonográfica intraoperatória de afecções do canal vertebral e estruturas do sistema nervoso em cães

Abstract

Intraoperative ultrasound can provide details on various conditions of the spinal cord and vertebral canal, such as: intervertebral disc disease (IVDD), stenosis of the vertebral canal, vertebral fractures, neoplasia, and foreign bodies in the vertebral canal. Our objective was to evaluate the feasibility, advantages and disadvantages of using intraoperative ultrasound in dogs undergoing spinal surgery. The vertebral canal of 18 dogs was examined with intraoperative ultrasonography. Ten dogs underwent spinal surgery for removal of herniated intervertebral disc material, three for stabilization of vertebral fracture and luxation, three for decompression of cauda equina, and two for removal of vertebral neoplasia. Particular attention was given to signs of cord compression, such as inability to visualize the central canal and unevenness of the hyperechoic lines that represent the meninges and the central canal. We found that intraoperative ultrasonography was feasible and useful in dogs undergoing surgery for spinal cord or cauda equina decompression and fracture stabilization. The use of intraoperative ultrasound for localization of the compressive material was not paramount when a location had been obtained via computed tomography (CT), but it showed alterations in spinal cord parenchyma in four dogs not observed on CT. Furthermore, it successfully confirmed adequate decompression of the spinal cord. Disadvantages were mainly related to scheduling. The principle advantages of intraoperative ultrasonography were: estimation of vascularization and extent of spinal cord lesion. Most importantly, it allowed real time evaluation of the spinal cord and conditions related to the vertebral canal, which permits modification of the surgical procedure.