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Comparative Evaluation of Postoperative Epidural Hematoma after Lumbar Microendoscopic Laminotomy: The Utility of Ultrasonography versus Magnetic Resonance Imaging.
Murata, Shizumasa; Iwasaki, Hiroshi; Hashizume, Hiroshi; Yukawa, Yasutsugu; Minamide, Akihito; Nakagawa, Yukihiro; Tsutsui, Shunji; Takami, Masanari; Okada, Motohiro; Nagata, Keiji; Ishimoto, Yuyu; Teraguchi, Masatoshi; Iwahashi, Hiroki; Murakami, Kimihide; Taiji, Ryo; Kozaki, Takuhei; Kitano, Yoji; Yoshida, Munehito; Yamada, Hiroshi.
Afiliación
  • Murata S; Department of Orthopedic Surgery, Shingu Municipal Medical Center, Shingu, Japan.
  • Iwasaki H; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Hashizume H; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Yukawa Y; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Minamide A; Spine Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
  • Nakagawa Y; Spine Center, Dokkyo Medical University Nikko Medical Center, Nikko, Japan.
  • Tsutsui S; Spine Care Center, Wakayama Medical University Kihoku Hospital, Ito, Japan.
  • Takami M; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Okada M; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Nagata K; Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, Wakayama, Japan.
  • Ishimoto Y; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Teraguchi M; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Iwahashi H; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Murakami K; Department of Orthopedic Surgery, Shingu Municipal Medical Center, Shingu, Japan.
  • Taiji R; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Kozaki T; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Kitano Y; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
  • Yoshida M; Department of Orthopedic Surgery, Shingu Municipal Medical Center, Shingu, Japan.
  • Yamada H; Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, Wakayama, Japan.
Spine Surg Relat Res ; 8(4): 433-438, 2024 Jul 27.
Article en En | MEDLINE | ID: mdl-39131405
ABSTRACT

Introduction:

Postoperative spinal epidural hematoma (PSEH) is a severe complication of spinal surgery that necessitates accurate and timely diagnosis. This study aimed to assess the accuracy of ultrasonography as an alternative diagnostic tool for PSEH after microendoscopic laminotomy (MEL) for lumbar spinal stenosis, comparing it with magnetic resonance imaging (MRI).

Methods:

A total of 65 patients who underwent MEL were evaluated using both ultrasound- and MRI-based classifications for PSEH. Intra- and interrater reliabilities were analyzed. Furthermore, ethical standards were strictly followed, with spine surgeons certified by the Japanese Orthopaedic Association performing evaluations.

Results:

Among the 65 patients, 91 vertebral segments were assessed. The intra- and interrater agreements for PSEH classification were almost perfect for both ultrasound (κ=0.824 [95% confidence interval (CI) 0.729-0.918] and κ=0.810 [95% CI 0.712-0.909], respectively) and MRI (κ=0.839 [95% CI 0.748-0.931] and κ=0.853 [95% CI 0.764-0.942], respectively). The results showed high concordance between ultrasound- and MRI-based classifications, validating the reliability of ultrasound in postoperative PSEH evaluation.

Conclusions:

This study presents a significant advancement by introducing ultrasound as a precise and practical alternative to MRI for PSEH evaluation. The comparable accuracy of ultrasound to MRI, rapid bedside assessments, and radiation-free nature make it valuable for routine postoperative evaluations. Despite the limitations related to specific surgical contexts and clinical outcome assessment, the clinical potential of ultrasound is evident. It offers clinicians a faster, cost-effective, and repeatable diagnostic option, potentially enhancing patient care. This study establishes the utility of ultrasound in evaluating postoperative spinal epidural hematomas after MEL. With high concordance to MRI, ultrasound emerges as a reliable, practical, and innovative tool, promising improved diagnostic efficiency and patient outcomes. Further studies should explore its clinical impact across diverse surgical scenarios.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Spine Surg Relat Res Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Spine Surg Relat Res Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón