Incremental risk factors for spinal cord injury following operation for acute traumatic aortic transection.

Of 35 patients operated upon for acute traumatic transection of the upper descending thoracic aorta between 1967 and March 31, 1980, 33 had sufficient information for us to analyze the incidence of spinal cord injury (paraplegia or paresis). This event occurred in eight patients. Multivariate analyses indicated that spinal cord injury was more likely to occur with long aortic cross-clamp times (p = 0.08) when no shunt was employed to perfuse the distal aorta during cross-clamping. The data suggest that if an aortic cross-clamp time exceeding about 30 minutes is anticipated, a shunt should be employed during aortic cross-clamping.