Pulse volume recording disturbances in paraplegic patients

Spinal cord injuries may modify vascular reactivity in the denervated region. This study presents an original observation of altered vascular response in paraplegic patients. A group of 30 consecutive paraplegic otherwise normal individuals underwent a thorough vascular examination. There were 29 male and 1 female patient, 21 to 67 years old (average 41), all with traumatic spinal cord injury. Average time since injury was 17 years. All had good peripheral pulses and normal segmental Doppler pressure measurements. In 8 patients, plethysmography--pulse volume recording (PVR) was normal as expected. In 22 patients an unusual feature of the vascular examination was recorded, consisting of normal peripheral arterial pressures with PVR waveforms indicating poor pulsatility. This group was older than the group with normal studies: ages 44 +/- 13 vs 34 +/- 8 years (p = 0.05), and more time had elapsed since injury-20 +/- 12 vs 10 +/- 4 years (p = 0.015). The altered pulsatility demonstrated in most of those paraplegic patients may play a role in deficient wound healing frequently observed below the level of spinal neurological loss.