Spinal cord protection: development of a paraplegia-preventive solution.

Abstract

We present a clinically available method to protect the spinal cord against ischemic or reperfusion injury and to prevent paraplegia after cross-clamping of the aorta. We separated 35 rabbits into five equal groups and clamped each animal's abdominal aorta distal to the left renal artery. We also occluded the aortas 2 cm above the iliac bifurcation for 45 minutes with inflated 5F balloon catheters. Through the catheter port distal to each balloon one of four different solutions was infused at 3 degrees C for 3 minutes at a rate of 5 mL/min (group I, uninfused control; group II, lactated Ringer's solution; group III, lactated Ringer's solution + 30 mg/kg of methylprednisolone; group IV, lactated Ringer's solution+methylprednisolone + 3 mL of 20% mannitol; group V, lactated Ringer's solution+methylprednisolone+mannitol + 10 mg/kg of vitamins E and C). We assessed the neurologic status of the hind limbs on the second postoperative day using Tarlov's criteria. The neurologic status in groups III, IV, and V was significantly superior to that of group I (p < 0.05, groups III versus I; p < 0.01, groups IV and V versus I). Spastic paraplegia occurred in 71% of group I, in 43% of group II, in 29% of group III, in 14% of group IV, and not at all in group V. The infusion of our specially blended solution with several spinal cord neuroprotective properties (hypothermia, methylprednisolone, mannitol, and vitamins E and C) achieved the best spinal cord protection against ischemic or reperfusion injury and prevented postoperative paraplegia.

• Authors: T Ueno, K Furukawa, Y Katayama, H Suda, T Itoh
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 58 Issue 1 Pg. 116-20 (Jul 1994) ISSN: 0003-4975 [Print] Netherlands
• PMID: 8037508 (Publication Type: Journal Article)

Chemical References

• Electrolytes
• Isotonic Solutions
• Ringer's Lactate
• Vitamin E
• Mannitol
• Ascorbic Acid
• Methylprednisolone

Topics

• Animals
• Aorta, Abdominal
• Ascorbic Acid (therapeutic use)
• Constriction
• Electrolytes
• Hindlimb (innervation)
• Hypothermia, Induced
• Isotonic Solutions (therapeutic use)
• Mannitol (therapeutic use)
• Methylprednisolone (therapeutic use)
• Osmolar Concentration
• Paraplegia (prevention & control)
• Rabbits
• Regional Blood Flow
• Reperfusion Injury (prevention & control)
• Ringer's Lactate
• Spinal Cord (blood supply)
• Time Factors
• Vitamin E (therapeutic use)