In summary, we found IOUS can be a useful tool in spine surgery for decompression in degenerative spine cases of the cervical, thoracic, and lumbar spine that included spondylosis, OPLL, and disc herniation. In the thoracic spine, IOUS was also helpful in the decompression of trauma cases for burst fractures, since it is difficult to assess anterior elements due to inability to mobilize spinal cord at this level. In the lumbar spine, IOUS had the added benefit of visualizing decompression of far lateral structures such as the exiting nerve roots. Although we would opine that we have achieved our goal of identifying a common definition for adequate decompression that involved a qualitative description of the spinal cord being "free floating" within the cerebrospinal fluid, there was insufficient evidence that this was related to clinical outcomes. Other definitions such as quantifiable (measures of spinal cord diameter) or spinal cord pulsatility were not good definitions, and had no clinical relevance.
No funds were received in support of this work.
No relevant financial activities outside the submitted work.
The authors thank Henry Lam for his help with our literature review.
Spine. 2022;47(2):E73-E85. © 2022 Lippincott Williams & Wilkins