Prevention of Paraplegia Secondary to Operations on the Thoracic Aorta

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Abstract
In spite of vastly improved surgical techniques to successfully manage lesions of the thoracic aorta, paraplegia continues to be a serious postoperative complication of such procedures. While the incidence of paraplegia is much higher in operations involving the distal descending thoracic aorta (1–11%),[1] it can occur following seemingly uncomplicated procedures on the; proximal descending aorta, such as repair of coarctation of the aortat[2,3] or deceleration injuries. Ischemia of the spinal cord due to temporary intraoperative interruption of its blood supply and/or division of intercostal arteries supplying blood to the cord appear to be the major etiological factors in the development of paraplegia following operations on the thoracic aorta. In order to prevent ischemia to the spinal cord during such operations, the thoracic surgeon needs to have knowledge of the arterial blood supply to the spinal cord.