In 2011, Harel and Knoller began to use Aloka Prosound Alpha 7 at the Sheba Medical Center during neurosurgical spinal tumor resection, thoracic disc herniation, and Chiari malformation. They retrospectively evaluated the volume of usage and the extent of intraoperative modification resulting from the use of IUS.

During 2011-2013 they identified 131 cases that IUS could be of assistance. IUS was used in 78 cases (59.5%); 37.5% in 2011, 65% in 2012 and 71% in 2013. IUS was routinely performed after exposure of the dura and repeated at the surgeon's request. As a whole, IUS changed the course of surgery in 63% of the cases.

IUS is safe and easy to use after a short learning curve. When used in indicated cases, it can replace cumbersome fluoroscopy, reduce the incision dimension and laminectomy levels, and demonstrate the extent of decompression. Incorporating IUS in spinal surgery education programs is warranted. 1).

Harel R, Knoller N. Intraoperative spine ultrasound: application and benefits. Eur Spine J. 2016; 25:865-869.
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