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Ann Thorac Surg 1994;58:112-115
© 1994 The Society of Thoracic Surgeons

Articles

Effect of altering cerebrospinal fluid pressure on spinal cord blood flow

Shigeru Kazama, MD*, Yoshihiko Masaki, BS, Shigeyoshi Maruyama, BS, Akira Ishihara, MD

Departments of Thoracic Surgery and Experimental Zoology, Kitasato University School of Medicine, Kanagawa, Japan

Accepted for publication November 20, 1993.

* Address reprint requests to Dr Kazama, Department of Thoracic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228, Japan.

Removal of cerebrospinal fluid (CSF) has been proposed as a means of protecting the spinal cord Against ischemic injury during thoracoabdominal aneurysm operations. We investigated the effect of altering CSF pressure (CSFP) on lumbar spinal cord blood flow (SCBF) in an experiment using dogs. The SCBF was measured before and after withdrawal of CSF in settings with and without thoracic aortic clamping. Furthermore, SCBF was measured at the basal state and after elevation of CSFP to 20 mm Hg and to 40 mm Hg. The SCBF did not change significantly before and after removal of CSF in settings both with and without thoracic aortic clamping. Elevation of CSFP significantly reduced SCBF. Elevation of CSFP reduces SCBF, but lowering CSFP per se does not increase SCBF whether the thoracic aorta is occluded or not. This supports the notion that removal of CSF offers spinal cord protection only when CSFP is abnormally elevated.




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