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Ann Thorac Surg 1999;67:1362-1369
© 1999 The Society of Thoracic Surgeons

Original Articles

Selective protection of gray and white matter during spinal cord ischemic injury1

Fabrizio M. Follis, MDa, Karen S. Blisard, MD, PhDa, Poseidon S. Varvitsiotis, MDa, Stuart B. Pett, Jr, MDa, R. Thomas Temes, MDa, Jorge A. Wernly, MDa

a Department of Cardiothoracic Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA

Accepted for publication November 25, 1998.

Address reprint requests to Dr Follis, Dept of Cardiothoracic Surgery, University of New Mexico Health Sciences Center, 2211 Lomas Blvd NE, Albuquerque, NM 87131
e-mail: follis{at}unm.edu

Background. Ischemic injury in the gray matter is associated with excitatory amino acid neurotransmitters (EAA) release, and in the white matter is associated with intracellular sodium accumulation. We investigated the protective effect during spinal ischemia of the EAA antagonist, 2-carboxypiperazinyl-propylphosphonic acid (CPP), and the sodium channel blocker (2,6-dimethylphenylcarbamoylmethyl) triethylammonium bromide (QX).

Methods. Sprague-Dawley rats were randomized in four groups, received intrathecally 10 µL of saline, CPP, QX, or QX/CPP, and underwent balloon occlusion of the aorta. Proximal pressure was lowered by exsanguination. In the acute protocol, 28 rats were used to calculate the length of occlusion, resulting in paraplegia in 50% of animals (P50). In the chronic study, 60 rats underwent 11' occlusion. The chronic animals were scored daily for 28 days and submitted to cord histology.

Results. The P50 of QX (11'22'') and QX/CPP (11'54'') were longer than saline (10'39''), suggesting a beneficial effect. Neurologic scores of all treatment groups (p = 0.0001) and histologic scores of CPP (p = 0.003) and QX/CPP (p = 0.002) were better than saline.

Conclusions. Protection of spinal cord during ischemia can be achieved with intrathecal administration of selective agents directed to the gray and white matter.




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