الفهرس | Only 14 pages are availabe for public view |
Abstract Background : Spinal cord ischaemia (SCI) is a devastating complication of abdominal aortic aneurysm (AAA) surgery with an incidence of 0.2-0.3% for endovascular aneurysm repair (EVAR) and open repair. Potential mechanisms include critical interruption of the spinal cord blood supply, thromboembolus, and perioperative hypotension . Aim of work : The aim of this work is to review and understand the pathophysiology of spinal cord injury during thoracic and thoraco abdominal aortic surgeries , risk factors and perioperative anesthetic management to protect the spinal cord . Conclusion : Spinal rescue strategies include systemic hypothermia, endovascular aortic repair, permissive systemic hypertension, cerebrospinal fluid drainage, pharmacologic neuroprotection,and intensive neuromonitoring. Despite an extensive body of literature and various proposals, a completely effective strategy to prevent or treat neurological injury remains elusive . |