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Spinal fluid dynamics during thoracic- and thoracoabdominal aortic surgery.
T O Eide1, P Romundstad, R Stenseth
1Department of Surgery, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway.
Summary
Elevated cerebrospinal fluid pressure (CSFP) during thoracic and thoracoabdominal aortic aneurysm repair correlated with postoperative neurologic deficits. Monitoring and draining cerebrospinal fluid (CSF) may be beneficial in preventing these complications.
Area of Science:
- Neurosurgery
- Cardiovascular Surgery
- Neurology
Background:
- Thoracic and thoracoabdominal aortic aneurysms pose significant surgical risks.
- Postoperative neurologic deficits are a major concern following these complex repairs.
Purpose of the Study:
- To investigate the relationship between cerebrospinal fluid pressure (CSFP) and drained cerebrospinal fluid (CSF) volume during and after aortic aneurysm repair.
- To correlate these findings with the incidence of postoperative neurologic deficits.
Main Methods:
- Twenty-nine patients undergoing thoracic or thoracoabdominal aortic aneurysm repair without shunting or extracorporeal circulation were studied.
- Intrathecal catheters were used for CSFP monitoring, and CSF volumes drained intraoperatively and postoperatively were recorded.
Main Results:
- Three out of 29 patients experienced postoperative neurologic sequelae (paraplegia or paraparesis).
- Patients with neurologic deficits had significantly higher intraoperative CSFP compared to those without (P=0.04).
- A positive correlation was observed between CSFP and central venous pressure.
Conclusions:
- Higher intraoperative CSFP is associated with neurologic sequelae after thoracic and thoracoabdominal aneurysm repair.
- While the study size is limited, findings suggest CSFP monitoring and drainage may be beneficial during these procedures.