Spinal cord injury following thoracic and thoracoabdominal aortic repairs

ObjectiveTo discuss the currently available approaches to prevent spinal cord injuryduring thoracic and thoracoabdominal aortic repairs.MethodsWe carried out a PubMed search up to 2013 using the Medical Subject Headings: “ aortic aneurysm/surgery” and “ spinal cordischemia”; “ aortic aneurysm, thoracic/surgery” and “ spinal cordischemia”; “aneurysm/surgery” and “ spinal cordischemia/cerebrospinal fluid”; “ aortic aneurysm/surgery” and “ paraplegia”. All 190 original articles satisfying our inclusion criteria were analyzed for incidence, predictors, and other pertinent variables related to spinal cord injury, and we compared the results in recent publications with those in earlier reports.ResultsThe mean age of the 38,491 patients was 65.3 ± 4.9 years. The overall incidence of paraplegiaand/or paraparesis was 7.1% ± 6.1% (range 0%–32%). The incidence of spinal cord injurybefore 2000, from 2001 to 2007, and 2008–2013 was 9.0% ± 6.7%, 7.0% ± 6.1%, and 5.9% ± 5.2%, respectively (p = 0.019). Various predictors ...