European Spine Journal

, Volume 27, Issue 11, pp 2763–2771 | Cite as

Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty: time-dependent changes

  • Yoshiharu NakayaEmail author
  • Atsushi Nakano
  • Kenta Fujiwara
  • Takashi Fujishiro
  • Sachio Hayama
  • Toma Yano
  • Masashi Neo
Original Article



The first purpose of this study is to confirm whether the spinal cord and the surrounding tissues can be visualized clearly after laminoplasty using percutaneous ultrasonography. And second purpose is to evaluate the changes in the status of the spinal cord over time.


Fifty patients who underwent cervical laminoplasty with suture anchors were evaluated using intraoperative ultrasonography and postoperative (1 week, 2 weeks, 3 months, 6 months, and 1 year) percutaneous ultrasonography. We classified the decompression status of the spinal cord into three grades and the pattern of the spinal cord pulsation into six categories. Clinical outcomes were evaluated using the Japanese Orthopaedic Association Score for cervical myelopathy, and the recovery rate was calculated.


In all cases and all periods, we could observe the status of the spinal cord using percutaneous ultrasonography after cervical laminoplasty. The decompression status of the spinal cord improved until 3 months postoperatively, and the clinical outcomes improved up to 6 months postoperatively. Although the pulsation pattern of the spinal cord varied in each individual and in each period, spinal pulsation itself was observed in all cases and all periods, except one, when an epidural hematoma caused quadriplegia and a revision surgery was needed. Decompression status and pulsation pattern of the spinal cord were not associated with clinical outcomes as far as pulsation was observed.


Percutaneous ultrasonography was very useful method to evaluate the postoperative status of the spinal cord, particularly in the diagnosis of the postoperative epidural hematoma.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Cervical laminoplasty Percutaneous ultrasonography Epidural hematoma Spinal cord dynamics 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethics review board of our institution; Osaka medical college (No. 2403).

Informed consent

For this type of study formal consent is not required according to the Japanese ethical guideline for clinical research. Instead, we provided the patients with the opportunity to opt out on website.

Supplementary material

Supplementary material 1 (MOV 69088 kb)

Supplementary material 2 (MOV 51776 kb)

Supplementary material 3 (MOV 74605 kb)

586_2018_5752_MOESM4_ESM.pptx (70.3 mb)
Supplementary material 4 (PPTX 71943 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryOsaka Medical CollegeOsakaJapan

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