Direct measurements of oxygen tension on the spinal cord surface of pigs after occlusion of the descending aorta.

Spinal cord injury is the most dreaded complication of operative procedures on the descending aorta. Our previous experimental study on pigs indicated that an increase in the cerebrospinal fluid pressure after aortic cross-clamping did not influence the occurrence of spinal cord injury. We therefore concluded that the cause of spinal cord injury after aortic cross-clamping is due to primary oxygen deficiency in the spinal cord distal to the occlusion site, especially in the area supplied by the artery of Adamkiewicz. The aim of the present study is to examine the primary ischemic cause of spinal cord injury after aortic cross-clamping by directly measuring the oxygen tension on the spinal cord surface in pigs. During the occlusion phase, oxygen tension decreased significantly distal to the clamping site and especially in the areas supplied by the artery of Adamkiewicz both after occlusion of the high thoracic (Group I) and the lumbar aorta (Group II). The marked decrease in oxygen tension proves that hypoxia is the primary reason for spinal cord injury. The presence of a "steal phenomenon" should be discussed.