Document Detail

Circulation of the spinal cord: an important consideration for thoracic surgeons.
MedLine Citation:
PMID:  12842576     Owner:  NLM     Status:  MEDLINE    
The spinal cord has significant thoracic arterial watershed areas rendering it vulnerable to intraoperative ischemic damage, clearly mandating a need for postoperative neurologic monitoring. Mechanisms of hypoperfusion include aortic cross-clamping, rib retraction, intercostal artery interruption, and costovertebral junction bleeding. We report cases of primary lung cancer resection, resection of pulmonary metastasis adherent to the thoracic aorta, resection of cartilaginous tumor with chest wall invasion, and esophagomyotomy for achalasia-all complicated by postoperative paraplegia. We review spinal cord circulation, describe mechanisms and patterns of neurologic dysfunction of susceptible watershed areas, and outline roles of preoperative spinal angiography and intraoperative evoked potentials.
Mohammed F Shamji; Donna E Maziak; Farid M Shamji; Robert J Ginsberg; Ron Pon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  76     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-04     Completed Date:  2003-10-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  315-21     Citation Subset:  AIM; IM    
Division of Thoracic Surgery, The Ottawa Hospital, General Campus, Ottawa, Ontario, Canada.
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MeSH Terms
Aorta, Thoracic / pathology,  surgery*
Iatrogenic Disease*
Intraoperative Complications / diagnosis
Lung Neoplasms / pathology,  surgery*
Middle Aged
Regional Blood Flow
Risk Assessment
Sampling Studies
Spinal Cord / blood supply
Spinal Cord Ischemia / diagnosis,  etiology*,  surgery
Thoracic Surgery / standards,  trends
Thoracic Surgical Procedures / adverse effects,  methods
Thoracotomy / adverse effects*,  methods
Vascular Neoplasms / secondary,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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