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Minerva Ortopedica e Traumatologica 2006 December;57(6):521-9

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: Italian

Ultrasonography of the vertebral canal in neonates and adults

Azzoni R. ¹, Gerevini S. ²

¹ Clinica Ortopedica Dipartimento di Scienze Medico-Chirugiche Facoltà di Medicina e Chirurgia Università degli Studi di Milano San Donato Milanese (MI) 2 Servizio di Neuroradiologia IRCCS Ospedale San Raffaele, Milano

The use of ultrasonography for studying congenital pathologies of the vertebral canal in neonates is an established diagnostic method; recently, ultrasound techniques have also been applied in the interoperative evaluation of certain acquired pathologies in adults. The authors describe how this technique is used in neonates and give an outline of normal echographic anatomy. The indications for diagnostic neonatal ultrasonography include occult dysraphism and a series of malformations known under the acronym VATER: vertebral defects, anal atresia, tracheoesophageal fistula, radial defects, renal anomalies. Various other malformations ultrasonography can detect are: myelocele, myelomeningocele, lipoma, short terminal filum, terminal myelocystocele, lateral meningocele, hydromyelia, syringomyelia and so forth. The identification and classification of these malformations have important implications for the treatment and prognosis of neurologic function. Also in delivery-related pathologies (lesions, hematoma) and iatrogenic lesions (laceration of the dura mater and the leptomeninges during lumbar puncture), prompt diagnosis plays a vital role. Ultrasound screening of subjects with strawberry nevi or hemangiomas or telangiectases, cutaneous dyschromia, hypertrichosis or focal hair tufts, lipoma, cutaneous sessile neoformations, skin depressions in the lumbosacral region is equally important. The use of ultrasound screening is also a valuable aid for examining the children of mothers with diabetes among whom there is a noted prevalence of spinal malformations. In adults, ultrasonography during the interoperative phase of echo-guided surgery may reduce the complications associated with surgical procedures or be employed as a standard method in at-risk patients. The literature reports numerous series confirming the value of ultrasonography as a rapid, precise, accurate, ubiquitous, economic, atraumatic and sensitive method. Ultrasound screening may constitute an initial step prior to computed tomography or magnetic nuclear resonance imaging studies in cases of abnormal findings or in presurgical treatment. When appropriately applied, ultrasonography in adults provides detailed diagnostic information and may be a useful aid in surgery.