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Clinical indicators of paraplegia underplay universal spinal cord neuronal injury from transient aortic occlusion.

作者信息

Bell Marshall T, Puskas Ferenc, Bennett Daine T, Cleveland Joseph C, Herson Paco S, Mares Joshua M, Meng Xainzhong, Weyant Michael J, Fullerton David A, Brett Reece T

机构信息

Department of Surgery, University of Colorado, Denver, CO, USA.

Department of Anesthesiology, University of Colorado, Denver, CO, USA.

出版信息

Brain Res. 2015 Aug 27;1618:55-60. doi: 10.1016/j.brainres.2015.04.053. Epub 2015 May 22.

Abstract

Paraplegia following complex aortic intervention relies on crude evaluation of lower extremity strength such as whether the patient can lift their legs or flex the ankle. Little attention has been given to the possible long-term neurologic sequelae following these procedures in patients appearing functionally normal. We hypothesize that mice subjected to minimal ischemic time will have functional and histological changes despite the gross appearance of normal function. Male mice underwent 3 min of aortic occlusion (n=14) or sham surgery (n=4) via a median sternotomy. Neurologic function was graded by Basso Motor Score (BMS) preoperatively and at 24h intervals after reperfusion. Mice appearing functionally normal and sham mice were placed on a walking beam and recorded on high-definition, for single-frame motion analysis. After 96 hrs, spinal cords were removed for histological analysis. Following 3 min of ischemia, functional outcomes were split evenly with either mice displaying almost normal function n=7 or near complete paraplegia n=7. Additionally, single-frame motion analysis revealed significant changes in gait. Histologically, there was a significant stepwise reduction of neuronal viability, with even the normal function ischemic group demonstrating significant loss of neurons. Despite the appearance of normal function, temporary ischemia induced marked cyto-architectural changes and neuronal degeneration. Furthermore high-definition gait analysis revealed significant changes in gait and activity following thoracic aortic occlusion. These data suggest that all patients undergoing procedures, even with short ischemic times, may have spinal cord injury that is not evident clinically.

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