Diagnosis and Prevention for Spinal Cord Injury using Spinal Cord Plegia and Spinal Cord Cooling Pad during Thoracic Aortic Aneurysm Surgery

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This study was scheduled to clarify the critical ischemic time to occur paraplegia during thoracic aortic aneurysm and how to diagnose the site of critical intercostals arteries and protect spinal cord from ischemic spinal cord injury.In animal experiements, efficacy of cold saline (spinal cord plegia) injection into the clamped aortia was investgated using evoked-spinal cord potentials during simple aortic cross clamping in canine model. Cold saline injection revealed prompt decrease of spinal cord potentials and minimized spinal cord injury, comparing with simple aortic cross clamping. Propofol (neuron protective agent) was added to the spinal cord plegia and examined how to decrease spinal cord injury after simple aortic cross clamping. Propofol was effective to decrease spinal cord injury during aortic cross clamping. Spinal cord cooling pad was also devised and used as a cooling instrument outside from the spine. Spinal cord cooling pad decreased spinal cord temperature quickly and protected spinal cord from ischemic injury.In clinical study, cold blood spinal cord plegia was infused into the clamped aorta during thoracoabdominal aortic aneurysm surgeries. Cold blood infusion decreased spinal cord evoked potentials quickly and effective to determine the location of the critical intercostal arteries in the clamped segment.