Intraoperative findings in spinal lesions

Ultrasonographic appearance of spinal tumors has been described in few studies until now, and the role of intraoperative ultrasound is not yet well standardized in spinal tumor surgery. To evaluate the spinal cord, probes with very high frequency (10 MHz or greater) can be used with outstanding spatial and temporal resolution. Before tumor removal, the lesion is identified, measured on axial and sagittal axes and defined as hyperechoic, isoechoic, or hypoechoic. Other characteristics of the lesions are considered: presence of calcifications, cystic/necrotic areas, diffuse or circumscribed appearance, and the relationships with the surrounding anatomical structures. Intraoperative ultrasonographic findings of different spinal tumors, according to histotypes and also to position, with respective pictorial essays are here presented. Intraoperative ultrasound is a valuable tool to detect spinal lesions, evaluate the surgical approach, and plan the surgical strategy, considering the position and relationships of the lesion with bony, neural, and vascular structures.