BACKGROUND: Spinal cord injury and subsequent paraplegia remains an unpredictable and devastating complication of thoracoabdominal aortic surgery. The aim of this study was to investigate spinal cord injury due to prolonged thoracoabdominal aortic occlusion. MATERIALS AND METHODS: We used a highly reproducible porcine model of 45-min thoracoabdominal aortic occlusion, which was accomplished by two balloon occlusion catheters. Neurological evaluation after the end of experiment was performed by an independent observer according to the Tarlov scale. The lower thoracic and lumbar spinal cords were harvested at 10, 48, and 120 h (n = 6 animals per time point) and examined histologically with hematoxylin and eosin (H&E) stain and TUNEL method. Tarlov scores, number of neurons, and the grade of inflammation were analyzed. RESULTS: H&E staining revealed reduction in the number of motor neurons which occurred in two phases (between 0 and 10 h and between 48 and 120 h of reperfusion), as well as development of inflammation in spinal cord sections during the reperfusion period, reaching a peak at 48 h. TUNEL reaction was negative for apoptotic neurons at any time point. CONCLUSIONS: In this porcine model, we demonstrated that, after 45 min of thoracoabdominal aortic occlusion, motor neuron death seems to occur in two phases (immediate and delayed). Inflammation was a subsequent event of transient prolonged spinal cord ischemia and possibly a major contributor of delayed neuronal death. Using TUNEL straining we found no evidence of neuronal apoptosis at any time point of reperfusion.
BACKGROUND:Spinal cord injury and subsequent paraplegia remains an unpredictable and devastating complication of thoracoabdominal aortic surgery. The aim of this study was to investigate spinal cord injury due to prolonged thoracoabdominal aortic occlusion. MATERIALS AND METHODS: We used a highly reproducible porcine model of 45-min thoracoabdominal aortic occlusion, which was accomplished by two balloon occlusion catheters. Neurological evaluation after the end of experiment was performed by an independent observer according to the Tarlov scale. The lower thoracic and lumbar spinal cords were harvested at 10, 48, and 120 h (n = 6 animals per time point) and examined histologically with hematoxylin and eosin (H&E) stain and TUNEL method. Tarlov scores, number of neurons, and the grade of inflammation were analyzed. RESULTS: H&E staining revealed reduction in the number of motor neurons which occurred in two phases (between 0 and 10 h and between 48 and 120 h of reperfusion), as well as development of inflammation in spinal cord sections during the reperfusion period, reaching a peak at 48 h. TUNEL reaction was negative for apoptotic neurons at any time point. CONCLUSIONS: In this porcine model, we demonstrated that, after 45 min of thoracoabdominal aortic occlusion, motor neuron death seems to occur in two phases (immediate and delayed). Inflammation was a subsequent event of transient prolonged spinal cord ischemia and possibly a major contributor of delayed neuronal death. Using TUNEL straining we found no evidence of neuronal apoptosis at any time point of reperfusion.
Authors: John Kuluz; Amer Samdani; David Benglis; Manuel Gonzalez-Brito; Juan P Solano; Miguel A Ramirez; Ali Luqman; Roosevelt De los Santos; David Hutchinson; Mike Nares; Kyle Padgett; Dansha He; Tingting Huang; Allan Levi; Randal Betz; Dalton Dietrich Journal: J Spinal Cord Med Date: 2010 Impact factor: 1.985
Authors: Florian Simon; Angelika Scheuerle; Michael Gröger; Brigitta Vcelar; Oscar McCook; Peter Möller; Michael Georgieff; Enrico Calzia; Peter Radermacher; Hubert Schelzig Journal: Intensive Care Med Date: 2011-07-16 Impact factor: 17.440
Authors: Hassan Albadawi; John W Chen; Rahmi Oklu; Yue Wu; Gregory Wojtkiewicz; Benjamin Pulli; John D Milner; Richard P Cambria; Michael T Watkins Journal: Radiology Date: 2016-08-10 Impact factor: 11.105
Authors: Christian Maier; Angelika Scheuerle; Balázs Hauser; Hubert Schelzig; Csaba Szabó; Peter Radermacher; Jochen Kick Journal: Intensive Care Med Date: 2007-03-15 Impact factor: 17.440
Authors: Adem Aslan; Mustafa Cemek; Mehmet Emin Buyukokuroglu; Korhan Altunbas; Orhan Bas; Yusuf Yurumez; Murat Cosar Journal: Eur Spine J Date: 2009-05-26 Impact factor: 3.134