Trans-vertebral Regional Cooling for Spinal Cord Protection during Thoracoabdominal Aortic Surgery : An Experimental Study
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概要
- 論文の詳細を見る
We developed a simple cooling method for spinal cord protection against ischemic injury during aortic surgery. The neuroprotective effects of our method were investigated using an animal study. Selective spinal hypothermia was produced by means of originally-designed cooling pads placed over the lower thoracic and lumbar vertebral column. Spinal cord ischemia was induced by cross-clamping the thoracic aorta for 60 min in beagle dogs. The neuroprotective effects were evaluated by a multi-modal study. The motor-evoked potentials of the spinal cord resulting from transcranial electric stimulation (MEPs) were recorded during both the ischemic and reperfusion periods. Hindlimb motor function was graded with the Tarlov score, and a histologic examination of the spinal cord injury was performed, at 24 hours after ischemia in animals undergoing hypothermia (hypothermia group: n = 7) or a sham (control group: n = 7). The spinal cord temperatures at the lower thoracic (T10) and lumbar (L3) levels decreased by -9.1°C per hour and -8.1°C per hour, respectively. The amplitude of the MEPs decreased during ischemia in both groups of animals, and significantly recovered during the early phase of aortic reperfusion in the hypothermia group. The Tarlov scores in the hypothermia and control groups were 3.3 ± 1.0 and 1.1 ± 1.5 (mean ± SD, p = 0.015), respectively. Histopathologic study revealed that ischemic injury of the lumbar cord was reduced in the animals undergoing hypothermia. Trans-vertebral regional cooling reduced ischemic spinal cord injury in a canine study. The current method is potentially feasible for clinical use, especially in view of its technical simplicity and few procedure-related complications.
- 広島大学の論文
著者
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Sueda T
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Sueda Taijiro
広島県厚生農業協同組合連合会廣島総合病院 外科
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Sueda Taijiro
Department Of Surgery Division Of Clinical Medical Science Graduate School Of Biomedical Sciences Hi
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Sueda Taijiro
Deaprtment Of Pediatric Surgery Graduate School Of Biomedical Science Hiroshima University
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Imai Katsuhiko
Department of Cardiovascular Surgery, Hiroshima University Hospital
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Okada Kenji
Department of Cardiovascular Surgery, Hiroshima University Hospital
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Orihashi Kazumasa
Department of Cardiovascular Surgery, Hiroshima University Hospital
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Kochi Kazuhiro
Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University
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SUGAWAEA Yuji
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences,
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Okada K
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Sueda Taijiro
Department Of Cardiovascular Surgery Hiroshima University Graduate School Of Medicine
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Sugawaea Yuji
Department Of Cardiovascular Surgery Graduate School Of Biomedical Science Hiroshima University
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Sugawara Yuji
Department Of Cardiovascular Surgery Fukuyama Cadiovascular Hospital
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Kochi Kazuhiro
Department Of Surgery Division Of Clinical Medical Science Graduate School Of Biomedical Sciences Hi
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Orihashi Kazumasa
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Okada Kenji
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Imai Katsuhiko
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Imai Katsuhiko
Department Of Cardiovascular Surgery Hiroshima University Graduate School Of Medicine
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Santo Takahiro
Department Of Surgery Division Of Clinical Medical Science Graduate School Of Biomedical Sciences Hi
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Okada Kenji
Department Of Applied Chemistry Okayama University Of Science
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Imai Katsuhiko
Department Of Cardiovascular Surgery Hiroshima University School Of Medicine
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Imai Katsuhiko
Department of Cardiovascular Surgery, Hiroshima University School of Medicine
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末田 泰二郎
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University
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スエダ タイジロウ
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University
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渡橋 和政
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University
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