Analysis of risk factors for postoperative spinal cord injury in patients with Stanford type A aortic dissection

Abstract

Objective To identify the risk factors for postoperative spinal cord injury in Stanford type A aortic dissection patients. Methods 210 Stanford type A aortic dissection(TAAD) patients underwent Sun’s procedure in Beijing Aortic Disease Center during July 2014 to March 2015. 14 patients had spinal cord injury after surgery. Clinical data and computed tomography angiography(CTA) imaging of aorta were retrospectively analyzed and multi-logistic regression analysis was performed to identify risk factors for spinal cord injury post operation. Results 14 out of 210(6.7%) patients had transient or permanent spinal cord injury after surgery. Univariate analysis showed only false lumen derived intercostal arteries at eighth thoracic vertebral level(T8) to first lumbar vertebral level(L1) was significantly associated with post-surgery spinal cord injury(P=0.000). Multi-logistic regression analysis showed that false lumen derived intercostal arteries(P=0.000) and age(P=0.016) were significantly associated with postoperative spinal cord injury. Conclusion Major intercostal arteries derived from false lumen and rapid thrombogenesis in false lumen are the major risk factors for postoperative spinal cord injury in Stanford type A aortic dissection patients. Key words: Aortic dissection Spinal cord injury Intercostal artery Cerebrospinal fluid drainage