Intraspinal pressure and spinal cord perfusion pressure after spinal cord injury: an observational study
Intraspinal pressure and spinal cord perfusion pressure after spinal cord injury: an observational study
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DOI：
10.3171/2015.3.spine14870
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发表时间：
2015-12-01
影响因子：
2.8
通讯作者：
Czosnyka, Marek
中科院分区：
文献类型：
--
作者：
Varsos, Georgios V.;Werndle, Melissa C.;Czosnyka, Marek
目的：与创伤性脑损伤（TBI）的颅内压（ICP）相比，创伤性脊髓损伤（TSCI）后的椎管内压（ISP）在波形分析方面没有得到同样的关注。基于最近引进的连续监测ISP的技术，这里观察描述ISP的形态特征。方法连续记录18例严重TSCI患者的ISP和动脉血压（ABP）。结果ISP脉搏波形态与ICP波形相似，由3个峰组成，分别代表叩击波、潮波和重搏波。频谱分析表明，慢，呼吸和脉搏波在不同的频率的存在。ISP的脉冲幅度与平均ISP成正比，表明与脑内空间相似的指数压力-容积关系。ISP和ABP的慢波之间的相互作用是能够表征的脊髓autoregulatory capability.CONCLUSIONS初步观察研究证实ISP在TSCI和ICP之间的形态和光谱的相似性。因此，用于ICP波形分析的已知方法可以转移到ISP分析，并且在验证后，可能用于监测TSCI患者。
OBJECT In contrast to intracranial pressure (ICP) in traumatic brain injury (TBI), intraspinal pressure (ISP) after traumatic spinal cord injury (TSCI) has not received the same attention in terms of waveform analysis. Based on a recently introduced technique for continuous monitoring of ISP, here the morphological characteristics of ISP are observationally described. It was hypothesized that the waveform analysis method used to assess ICP could be similarly applied to ISP.METHODS Data included continuous recordings of ISP and arterial blood pressure (ABP) in 18 patients with severe TSCI.RESULTS The morphology of the ISP pulse waveform resembled the ICP waveform shape and was composed of 3 peaks representing percussion, tidal, and dicrotic waves. Spectral analysis demonstrated the presence of slow, respiratory, and pulse waves at different frequencies. The pulse amplitude of ISP was proportional to the mean ISP, suggesting a similar exponential pressure-volume relationship as in the intracerebral space. The interaction between the slow waves of ISP and ABP is capable of characterizing the spinal autoregulatory capacity.CONCLUSIONS This preliminary observational study confirms morphological and spectral similarities between ISP in TSCI and ICP. Therefore, the known methods used for ICP waveform analysis could be transferred to ISP analysis and, upon verification, potentially used for monitoring TSCI patients.