Document Detail

The Pressure Distribution of Cerebrospinal Fluid Responds to Residual Compression and Decompression in an Animal Model of Acute Spinal Cord Injury.
MedLine Citation:
PMID:  22869059     Owner:  NLM     Status:  Publisher    
STRUCTURED ABSTRACT: Study Design. In vivo large animal (pig) model study of cerebrospinal fluid (CSF) pressures following acute experimental spinal cord injury (SCI).Objective. To determine how the CSF pressure (CSFP) and pulse pressure amplitude (CSFPPA) cranial and caudal to the injury site change after an acute SCI with subsequent thecal occlusion and decompression.Summary of Background Data. Lowering intrathecal pressure via CSF drainage is currently instituted to prevent ischemia-induced SCI during thoracoabdominal aortic aneurysm surgery and was recently investigated as a potential intervention for acute traumatic SCI. However, in SCI patients, persistent extradural compression commonly occludes the subarachnoid space. This may generate a CSFP differential across the injury site, which cannot be appreciated with lumbar catheter pressure measurements.Methods. Anesthetized pigs were subjected to an acute contusive SCI at T11 and eight hours of sustained compression (N = 12), or sham surgery (N = 2). CSFP was measured cranial and caudal to the injury site, using miniature pressure transducers, during compression and for six hours post-decompression.Results. The cranial-caudal CSFP differential increased (mean 0.39 mmHg/hr), predominantly due to increased cranial pressure. Upon decompression, cranial CSFP decreased (mean -1.16 mmHg) and caudal CSFP increased (mean 0.65 mmHg). The CSFP differential did not change significantly after decompression. Cranial CSFPPA was greater than caudal CSFPPA, but this differential did not change during compression. Upon decompression the caudal CSFPPA increased in some but not all animals.Conclusion. While extradural compression exists at the site of injury, lumbar CSFP may not accurately indicate CSFP cranial to the injury. Decompression may provide immediate, though perhaps partial, resolution of the pressure differential. CSFPPA was not a consistent indicator of decompression in this animal model. These findings may have implications for the design of future clinical protocols in which CSFP is monitored after acute SCI.
Claire F Jones; Robyn S Newell; Jae H T Lee; Peter A Cripton; Brian K Kwon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-3
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation: University of British Columbia, Orthopaedic and Injury Biomechanics Laboratory, Departments of Mechanical Engineering and Orthopaedics, Vancouver, British Columbia, Canada; University of British Columbia, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.
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