Fig. 4: Intraoperative use of TAUT for spinal cord stretch differentiation.

a A posterior vertebral column subtraction osteotomy (PVCSO) surgery was conducted to alleviate tension across the spinal cord of a patient diagnosed with recurrent TCS. By decreasing the height of the patient via bone removal, the distance that the cord stretches should be reduced. To intraoperatively evaluate the presence of (and changes in) tension, ultrasound was utilized to induce and record shear waves. Images from before (the fourth pre-acquisition) and midway through (the third mid-acquisition) the procedure are shown for Case A. Both columns include a single B-mode anatomical capture, shear wave propagation display, and the corresponding SWV heatmap. b SWV datapoints from all ultrasound image acquisitions pre- and mid-shortening are plotted from Case A. The violin plots and the corresponding interquartile ranges (IQR) are displayed to help visualize the distribution of SWV sub-sampling which compose our dataset. The following number of sub-samples are present from pre-image one to mid-image five: 76, 60, 72, 84, 76, 116, 72, 64, 96, and 112. The decrease in spinal cord tension between surgical timepoints was captured by TAUT (***p < 0.001). Additional information regarding statistics including p-values can be found in Supplementary Data 1.