Davidovic L, Ilic N
Faculty of Medicine, University of Belgrade Belgrade, Serbia -
J Cardiovasc Surg (Torino). 2014 Dec;55(6):741-57. Epub 2014 Jul 14.
This article discusses the etiology of spinal cord ischemia (SCI) mechanisms that may lead to paraplegia during open and endovascular repair from an anatomical and physiological perspective as well as the role of various protective measures used in prevention of this dreadful complication of aortic surgery. There are many adjuncts that must be considered to reduce the risk of spinal cord injury, such as revascularisation of intercostal arteries, maintenance of high mean blood pressure, spinal cord drainage and a few new promising models like NIRS and MISACE which usefulness is yet to be determined. These measures and techniques as well as possible etiology mechanisms of SCI are discussed, highlighting the evidence available for each method, the practical ways in which they may be used, giving some new theories and explanations.
本文从解剖学和生理学角度探讨了脊髓缺血（SCI）的病因机制，这些机制可能导致开放手术和血管内修复过程中的截瘫，以及各种预防措施在预防主动脉手术这一可怕并发症中的作用。为降低脊髓损伤风险，必须考虑许多辅助措施，如肋间动脉再血管化、维持较高平均血压、脊髓引流以及一些新的有前景的模式，如近红外光谱（NIRS）和微创主动脉腔内修复术中脊髓缺血评估（MISACE），其有效性尚待确定。本文讨论了这些措施和技术以及SCI可能的病因机制，强调了每种方法的现有证据、它们可能的实际应用方式，并给出了一些新的理论和解释。
