{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:12:25Z","timestamp":1780402345372,"version":"3.54.1"},"reference-count":9,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Intraoperative ultrasound was explored in the 1980s to assess lumbar spinal decompression; however, conventional probes require large bony windows and are poorly suited for minimally invasive surgery. This technical note evaluates the feasibility of intraoperative intraspinal endosonography (IOISES) using a miniaturized linear ultrasound probe introduced directly into the spinal canal through a microsurgical access corridor. Methods: This observational feasibility study included two patients undergoing lumbar spine surgery (microdiscectomy for disc herniation and decompression for spinal stenosis). After decompression and hemostasis, a miniaturized linear probe (Fujifilm L51K) connected to an Arietta A65 system was inserted into the spinal canal via an extended interlaminar approach. Imaging was performed prior to wound closure. The primary outcome was the technical feasibility of probe insertion and image acquisition. The secondary outcomes included intraoperative usability, visualization of neural structures, and integration into the surgical workflow. Results: Probe insertion and imaging were successful in both cases (100%). IOISES enabled high-resolution visualization of the dural sac and nerve roots, allowing intraoperative visualization of the extent of decompression. Probe handling and rotation were feasible without forced manipulation. No adverse events occurred, and the technique was integrated into the surgical workflow without prolonging operative time. Conclusions: IOISES is technically feasible and enables real-time intraspinal visualization during minimally invasive spinal surgery. This approach represents a shift from extraspinal to intraspinal ultrasound imaging. Further studies are required to evaluate reproducibility and clinical impact.<\/jats:p>","DOI":"10.3390\/jcm15114090","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T15:05:08Z","timestamp":1779721508000},"page":"4090","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of Intraoperative Intraspinal Endosonography Using a Miniaturized Ultrasound Probe Through an Extended Interlaminar Lumbar Approach: A Pilot Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8795-6790","authenticated-orcid":false,"given":"Ralf","family":"Stroop","sequence":"first","affiliation":[{"name":"Faculty of Health, Department of Medicine, Witten-Herdecke University, 58455 Witten, Germany"},{"name":"Department of Human Medicine, Faculty of Medicine, Medical School Hamburg, 20457 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9592-3881","authenticated-orcid":false,"given":"Samer","family":"Zawy Alsofy","sequence":"additional","affiliation":[{"name":"Faculty of Health, Department of Medicine, Witten-Herdecke University, 58455 Witten, Germany"},{"name":"Department of Neurosurgery, Academic Hospital of University M\u00fcnster, St. Barbara-Hospital, 59073 Hamm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Academic Hospital K\u00f6ln-Merheim, Witten-Herdecke University, 51072 K\u00f6ln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0601-9223","authenticated-orcid":false,"given":"Moritz","family":"Wegner","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937 K\u00f6ln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Ewelt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Academic Hospital of University M\u00fcnster, St. Barbara-Hospital, 59073 Hamm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","first-page":"751","article-title":"Intraoperative sonography during lumbar laminectomy: Work in progress","volume":"5","author":"Gooding","year":"1984","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"821","DOI":"10.2214\/ajr.154.4.2107683","article-title":"Lumbar disk herniation and canal stenosis: Value of intraoperative sonography in diagnosis and surgical management","volume":"154","author":"Montalvo","year":"1990","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.ultrasmedbio.2008.12.014","article-title":"Detection of residual disc hernia material and confirmation of nerve root decompression at lumbar disc herniation surgery by intraoperative ultrasound","volume":"35","author":"Aoyama","year":"2009","journal-title":"Ultrasound Med. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Peng, C., Wu, H., Kim, S., Dai, X., and Jiang, X. (2021). Recent Advances in Transducers for Intravascular Ultrasound (IVUS) Imaging. Sensors, 21.","DOI":"10.3390\/s21103540"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11488","DOI":"10.21037\/jtd-2025-1202","article-title":"A comprehensive review of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): Staging, techniques, and future directions","volume":"17","author":"Fiore","year":"2025","journal-title":"J. Thorac. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3881","DOI":"10.1007\/s00542-015-2775-1","article-title":"A highly compact packaging concept for ultrasound transducer arrays embedded in neurosurgical needles","volume":"23","author":"Schiavone","year":"2017","journal-title":"Microsyst. Technol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1177\/2192568217700100","article-title":"Use of Intraoperative Ultrasound During Spinal Surgery","volume":"7","author":"Vasudeva","year":"2017","journal-title":"Glob. Spine J."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Patel, M.R., Jacob, K.C., Parsons, A.W., Chavez, F.A., Ribot, M.A., Munim, M.A., Vanjani, N.N., Pawlowski, H., Prabhu, M.C., and Singh, K. (2022). Systematic Review: Applications of Intraoperative Ultrasonography in Spinal Surgery. World Neurosurg., 164.","DOI":"10.1016\/j.wneu.2022.02.130"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13037-018-0157-1","article-title":"Incidence of early postoperative complications requiring surgical revision for recurrent lumbar disc herniation after spinal surgery: A retrospective observational study of 9,310 patients from the German Spine Register","volume":"12","author":"Meyer","year":"2018","journal-title":"Patient Saf. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4090\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:48:46Z","timestamp":1780400926000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4090"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":9,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15114090"],"URL":"https:\/\/doi.org\/10.3390\/jcm15114090","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]}}}