Download PDF
Thorac Cardiovasc Surg 2016; 64(04): 333-335
DOI: 10.1055/s-0035-1552579
How to Do It
Georg Thieme Verlag KG Stuttgart · New York

Indirect Neuromonitoring of the Spinal Cord by Near-Infrared Spectroscopy of the Paraspinous Thoracic and Lumbar Muscles in Aortic Surgery

Maximilian Luehr
1   Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Sachsen, Germany
,
Friedrich-Wilhelm Mohr
1   Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Sachsen, Germany
,
Christian D. Etz
1   Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Sachsen, Germany
› Author Affiliations
Further Information

Publication History

09 January 2015

18 March 2015

Publication Date:
26 May 2015 (online)

    Permissions and Reprints All articles of this category

Abstract

Paraplegia remains the most devastating complication of open and endovascular thoracic/thoracoabdominal aortic aneurysm (TAA/A) repair. However, the assessment of currently available neuromonitoring modalities remains challenging and difficult to interpret. Near-infrared spectroscopy (NIRS) has been introduced as a strategy for noninvasive, real-time monitoring of the paraspinous collateral network (CN) to detect potential spinal cord ischemia at our institution. Prior to TAA/A repair, a cerebrospinal fluid catheter is placed and four NIRS optodes are bilaterally positioned on the patient's back to transcutaneously monitor regional muscle oxygenation at the thoracic and lumbar levels. Indirect surveillance of the spinal cord by NIRS seems to be a tempting option with increasing evidence supporting the CN concept.

Keywords

aorta/aortic - spinal cord - aneurysm
 

  • References

  • 1 Griepp RB, Griepp EB. Spinal cord perfusion and protection during descending thoracic and thoracoabdominal aortic surgery: the collateral network concept. Ann Thorac Surg 2007; 83 (2) S865-S869 , discussion S890–S892
    CrossrefPubMedGoogle Scholar
  • 2 Etz CD, von Aspern K, Gudehus S , et al. Near-infrared spectroscopy monitoring of the collateral network prior to, during, and after thoracoabdominal aortic repair: a pilot study. Eur J Vasc Endovasc Surg 2013; 46 (6) 651-656
    CrossrefPubMedGoogle Scholar
  • 3 Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth 2009; 103 (Suppl. 01) i3-i13
    CrossrefPubMedGoogle Scholar
  • 4 Etz CD, Luehr M, Kari FA , et al. Paraplegia after extensive thoracic and thoracoabdominal aortic aneurysm repair: does critical spinal cord ischemia occur postoperatively?. J Thorac Cardiovasc Surg 2008; 135 (2) 324-330
    CrossrefPubMedGoogle Scholar
  • 5 LeMaire SA, Ochoa LN, Conklin LD , et al. Transcutaneous near-infrared spectroscopy for detection of regional spinal ischemia during intercostal artery ligation: preliminary experimental results. J Thorac Cardiovasc Surg 2006; 132 (5) 1150-1155
    CrossrefPubMedGoogle Scholar