Monitoring of Spinal Cord Perfusion Pressure in Acute Spinal Cord Injury

Abstract

Our findings provide proof-of-principle that subdural intraspinal pressure at the injury site can be measured safely after traumatic spinal cord injury.

Intramedullary Lesion Length on Postoperative Magnetic Resonance Imaging is a Strong Predictor of ASIA Impairment Scale Grade Conversion Following Decompressive Surgery in Cervical Spinal Cord Injury

“…23–25,27,46,53–60 Verification of spinal cord decompression by MRI has been recently reported by Phang and colleagues at Cambridge University. 49,61,62 …”

Associations Between Anesthetic Variables and Functional Outcome in Dogs With Thoracolumbar Intervertebral Disk Extrusion Undergoing Decompressive Hemilaminectomy

“…Although the oscillometric monitor used in this study1 has previously been evaluated for validity with encouraging results,53 this method does reduce the accuracy of measurements when compared to direct arterial measurement and the results should be considered in light of this. Future studies could therefore better evaluate associations between hemodynamic anesthetic variables and long‐term outcome by utilizing more consistent techniques for prospectively monitoring intraoperative systemic perfusion parameters, such as continuously recorded direct arterial blood pressure recordings,26 as well as defined anesthetic medication protocols and using recently described methods for directly monitoring local indicators of tissue perfusion such as spinal cord blood flow and intraspinal pressure 19, 22, 23, 48. A prospective design in future studies could also utilize recordings of other downstream indicators of tissue perfusion such as plasma l ‐lactate concentration.…”

“…It has long been recognized in the experimental setting that perfusion of the spinal cord is highly associated with outcome 16, 17, 18. Recent human and veterinary studies have furthered our understanding of the role of spinal cord perfusion and hemodynamic changes, as well as the benefits of taking appropriate measures to maintain optimal spinal cord blood flow 19, 20, 21, 22, 23. Spinal cord perfusion is dependent on the relationship between systemic blood pressure and intrathecal pressure, in the same way that cerebral perfusion pressure is defined by mean arterial blood pressure (MABP) and intracranial pressure 17, 19, 24.…”

“…Recent human and veterinary studies have furthered our understanding of the role of spinal cord perfusion and hemodynamic changes, as well as the benefits of taking appropriate measures to maintain optimal spinal cord blood flow 19, 20, 21, 22, 23. Spinal cord perfusion is dependent on the relationship between systemic blood pressure and intrathecal pressure, in the same way that cerebral perfusion pressure is defined by mean arterial blood pressure (MABP) and intracranial pressure 17, 19, 24. Systemic hypotension might have serious consequences for the injured spinal cord, and alongside the avoidance of systemic hypoxia, management of blood pressure remains the mainstay of neuroprotective treatment in veterinary and human acute SCI 7, 19, 21, 25, 26…”

“…Spinal cord perfusion is dependent on the relationship between systemic blood pressure and intrathecal pressure, in the same way that cerebral perfusion pressure is defined by mean arterial blood pressure (MABP) and intracranial pressure 17, 19, 24. Systemic hypotension might have serious consequences for the injured spinal cord, and alongside the avoidance of systemic hypoxia, management of blood pressure remains the mainstay of neuroprotective treatment in veterinary and human acute SCI 7, 19, 21, 25, 26…”