Trans-vertebral Regional Cooling for Spinal Cord Protection during Thoracoabdominal Aortic Surgery : An Experimental Study

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Title ( eng )
Trans-vertebral Regional Cooling for Spinal Cord Protection during Thoracoabdominal Aortic Surgery : An Experimental Study
Creator
Sugawara Yuji
Orihashi Kazumasa
Okada Kenji
Kochi Kazuhiro
Contributors 国立情報学研究所
Source Title
Hiroshima Journal of Medical Sciences
Volume 52
Issue 3
Start Page 35
End Page 41
Journal Identifire
[PISSN] 0018-2052
[EISSN] 2433-7668
[NCID] AA00664312
Abstract
We developed a simple cooling method for spinal cord protection against ischemic injury during aortic surgery. The neuroprotective effects of our method were investigated using an animal study. Selective spinal hypothermia was produced by means of originally-designed cooling pads placed over the lower thoracic and lumbar vertebral column. Spinal cord ischemia was induced by cross-clamping the thoracic aorta for 60 min in beagle dogs. The neuroprotective effects were evaluated by a multi-modal study. The motor-evoked potentials of the spinal cord resulting from transcranial electric stimulation (MEPs) were recorded during both the ischemic and reperfusion periods. Hindlimb motor function was graded with the Tarlov score, and a histologic examination of the spinal cord injury was performed, at 24 hours after ischemia in animals undergoing hypothermia (hypothermia group: n = 7) or a sham (control group: n = 7). The spinal cord temperatures at the lower thoracic (T10) and lumbar (L3) levels decreased by -9.1°C per hour and -8.1°C per hour, respectively. The amplitude of the MEPs decreased during ischemia in both groups of animals, and significantly recovered during the early phase of aortic reperfusion in the hypothermia group. The Tarlov scores in the hypothermia and control groups were 3.3 ± 1.0 and 1.1 ± 1.5 (mean ± SD, p = 0.015), respectively. Histopathologic study revealed that ischemic injury of the lumbar cord was reduced in the animals undergoing hypothermia. Trans-vertebral regional cooling reduced ischemic spinal cord injury in a canine study. The current method is potentially feasible for clinical use, especially in view of its technical simplicity and few procedure-related complications.
Keywords
Spinal cord ischemia
Spinal cord protection
Cooling method
Thoracoabdominal aortic surgery
NDC
Medical sciences [ 490 ]
Language
eng
Resource Type departmental bulletin paper
Publisher
Hiroshima University Medical Press
Date of Issued 2003-09
Publish Type Version of Record
Access Rights open access
Date
[Created] 2006-03-21
Source Identifier
[ISSN] 0018-2052
[NCID] AA00664312