ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Intraoperative shear wave elastography during surgical treatment of intramedullary spinal cord tumors.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveShear wave elastography (SWE) quantifies tissue stiffness and has demonstrated utility in oncological imaging, but its application to intramedullary spinal cord tumors remains limited. This study evaluated the feasibility and utility of intraoperative SWE for characterizing stiffness properties of intramedullary tumors.
methodsWe prospectively enrolled 20 patients undergoing intramedullary tumor resection. Intraoperative B-mode and SWE imaging were performed before dural opening. Elastographic parameters were compared across histological grades and tumor types.
resultsOf 20 enrolled patients, 15 were included in the final analysis after excluding 4 with inadequate surgical exposure (< 7.5 cm) and 1 due to equipment unavailability. SWE successfully quantified tumor stiffness in all 15 cases without complications. High-grade gliomas (WHO grade 4, n = 2) demonstrated significantly higher stiffness than low-grade tumors (median Emean 69.8 vs. 13.8 kPa, p = 0.038). Within the low-grade cohort (n = 13), no significant stiffness difference was observed between astrocytomas and ependymomas (p = 0.171). Additionally, exploratory analysis in low-grade tumors (n = 13) revealed an association between higher tumor stiffness and better 12-month functional outcomes as measured by the Japanese Orthopedic Association score (p = 0.030).
conclusionIntraoperative SWE is feasible and safe for real-time quantitative stiffness quantification of intramedullary tumors. These exploratory findings suggest potential utility for tumor grading and prognostic stratification, warranting validation in larger prospective cohorts.
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