Current strategies for spinal cord protection during thoracic and thoracoabdominal aortic aneurysm repair

Surgery for thoracoabdominal aortic aneurysms remains challenging, with high mortality and morbidity rates despite overall improvements in the outcome of aortic surgery. Paraplegia and paraparesis remain devastating complications that severely restrict the chance of survival as well as the postoperative quality of life. Preventive measures vary considerably because the causes of spinal cord insufficiency are multifactorial. Here, we review measures to prevent paraplegia/paraparesis arising after surgery for thoracic and thoracoabdominal aortic aneurysms.