Commentary: NO matter what you call it, “conditioning” the spinal cord preventing paraplegia is worthwhile

Abstract

Postoperative spinal cord ischemia, resulting in paraplegia, remains one of the most dreaded complications of thoracic aortic surgery. Paraplegia results in increased mortality and poor long-term survival. Despite recent advancements in the perioperative strategies for spinal cord protection, composite and permanent spinal cord deficits occurred in 9.6% and 5.4% of 3309 thoracoabdominal aortic aneurysm repairs in the best hands. The delayed spinal cord deficit resulting in permanent paraplegia and paraparesis occurred in 1.4% and 1.6% of these patients. 1 These complications warrant exploration into novel methods of spinal cord protection, beyond perioperative perfusion strategies, cerebrospinal fluid drainage, and utility of collateralization. In their