Ultrasonography is more accurate than percutaneous palpation for identifying targeted thoracolumbar intervertebral disc spaces in dogs. Issue 6 (29th July 2018)

• Record Type: Journal Article
• Authors: Boursier, Jean‐François; Fournet, Alexandre; Bassanino, Jean; Manassero, Mathieu; Bedu, Anne‐Sophie; Leperlier, Dimitri
• Is Part Of: Veterinary radiology & ultrasound. Volume 59:Issue 6(2018)
• Page Start: 749
• Page End: 757
• Publication Date: 2018-07-29
• Subjects: canine -- image guided -- intervertebral disc disease -- spine -- vertebral level; Veterinary radiology -- Periodicals; Radiologie vétérinaire -- Périodiques; Échographie vétérinaire -- Périodiques; Radiography -- Periodicals; Ultrasonography -- Periodicals; Diagnosis -- Periodicals; Veterinary Medicine -- Periodicals; Societies, Medical -- Periodicals; 636.089607
• DOI: 10.1111/vru.12672
• Languages: English
• ISSNs: 1058-8183

Abstract

Abstract: During minimally invasive spinal surgery, correct identification of the affected intervertebral disc space is critical. Percutaneous palpation is commonly used, but results may be unreliable. Fluoroscopy is the gold standard but can be cumbersome and exposes operators to ionizing radiation. Spinal ultrasound has been described in veterinary medicine and could be a feasible alternative. This prospective, methods comparison study mimicked a minimally invasive spinal surgery in 10 canine cadavers and compared the accuracy of ultrasound and percutaneous palpation for thoracolumbar intervertebral disc space identification, using fluoroscopy as the reference standard. For each experiment, a disc space was randomly chosen. Identification was then attempted using both percutaneous palpation and ultrasound. For ultrasound, a linear probe was used to guide the operator to the correct location. The time necessary to perform each method was recorded. Accuracies for each method were calculated and statistically compared. Effects of body condition score, location of the targeted thoracolumbar intervertebral disc space and learning curve for each method were also evaluated. Ultrasonographic identification was more accurate (96.7% vs. 76.7%; P < 0.03) but took longer (147 s vs. 29 s; P < 0.0001) than percutaneous palpation. Findings from this cadaver study indicated that percutaneous palpation alone had low accuracy for correctly identifying a targeted thoracolumbar intervertebral disc space and supported the use of ultrasound as a method for improving the accuracy. Future studies are needed to assess the method in clinical cases, especially in obese dogs and/or those in which the targeted site is distant from palpable anatomical landmarks.