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Molecular Mechanism of Ischemic Damage to the Spinal Cord and Its Protection

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Neuroanesthesia and Cerebrospinal Protection

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Abstract

One of the most fearful complications after thoracoabdominal aortic aneurysm surgery is spinal cord ischemia. Ischemic spinal cord damage is considered to occur through essentially the same mechanism as ischemic brain damage. While brain ischemia research generally focuses on vulnerable neurons such as those in the hippocampus, that on spinal cord ischemia usually focuses on motor neurons. Furthermore, ischemic damage to the long nerve fibers that comprise the conduction path in the spinal cord is also recognized as an important problem.

Delayed spinal cord damage may occur after surgery for thoracoabdominal aortic aneurysm. It is unknown as to whether delayed spinal cord damage in humans occurs through the same mechanism as it does in animal models. In rabbit models, the onset of delayed spinal cord damage is accompanied by considerable ischemia-related change in the gray matter of the spinal cord. In contrast, delayed spinal cord damage following surgery for thoracoabdominal aortic aneurysm is often resolved by improving spinal cord perfusion. This must be taken into account when extrapolating the results of animal studies to humans.

Free radicals appear to play an important role in both the pathogenesis of ischemia-reperfusion damage and the acquisition of ischemic tolerance. A large amount of free radicals causes cellular damage, while an appropriate amount plays an important role in signal transduction. This implies that treatment strategies to completely eliminate free radicals, even during ischemia-reperfusion, are not necessarily successful. Fine control of free radicals appears to be important for spinal cord protection.

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Authors and Affiliations

  1. Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, 1-1-1, MinamiKogushi, Ube City, Yamaguchi, 755-8505, Japan

    Mishiya Matsumoto M.D. & Atsuo Yamashita M.D.

Authors
  1. Mishiya Matsumoto M.D.
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  2. Atsuo Yamashita M.D.
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Correspondence to Mishiya Matsumoto M.D. .

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Editors and Affiliations

  1. Tokyo Medical University, Tokyo, Japan

    Hiroyuki Uchino

  2. Kurume University, Fukuoka, Fukuoka, Japan

    Kazuo Ushijima

  3. Tokyo Medical University Hachioji Medical Center, Tokyo, Tokyo, Japan

    Yukio Ikeda

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Matsumoto, M., Yamashita, A. (2015). Molecular Mechanism of Ischemic Damage to the Spinal Cord and Its Protection. In: Uchino, H., Ushijima, K., Ikeda, Y. (eds) Neuroanesthesia and Cerebrospinal Protection. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54490-6_5

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  • DOI: https://doi.org/10.1007/978-4-431-54490-6_5

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54489-0

  • Online ISBN: 978-4-431-54490-6

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