Researchers conducted a retrospective study. For an investigation, they sought to determine if percutaneous ultrasonography (PUS) could be used to diagnose postoperative epidural hematoma (EH) as a postoperative complication. By comparing postoperative magnetic resonance imaging (MRI) and PUS of the spinal cord, investigators evaluated the use of PUS for identifying the necessity for surgical evacuation of postoperative EH. Patients who underwent cervical laminoplasty with suture anchors were included in the study. About 1  week after surgery, a routine MRI and PUS were done. MRI and PUS were conducted if the patients’ neurological condition deteriorated. The spinal cord decompression status was graded into 3 categories using MRI and PUS. In addition, PUS was used to assess the presence of spinal pulsation. Around 131 patients were looked into. The decompression state determined by MRI and PUS and the pulsation status determined by PUS were found to be related to neurological deterioration (P<0.001). In 4 instances required revision surgery due to postoperative neurological worsening. Both MRI and PUS classified the decompression condition in these patients as “poor,” and PUS pulsation classified it as “no-pulsation.” In MRI decompression, the sensitivity and specificity for neurological deterioration were 100% and 95.1%, respectively, in PUS decompression, 100%, 92.9%, and 100% and 99.2% in PUS pulsation. This was the first time that the loss of spinal beating has been linked to neurological decline. PUS helped assess whether postoperative EH necessitated surgical evacuation. In the event of postoperative neurological worsening after a cervical laminoplasty, PUS should be the initial examination option. A further hematoma evacuation procedure should be considered without waiting for an MRI as soon as the pulsation has vanished.

 

Source:journals.lww.com/jspinaldisorders/Abstract/2022/02000/Usefulness_of_Percutaneous_Ultrasonography_for.41.aspx