title: The effects of intrathecal hypotension on tissue perfusion and pathophysiological outcome after acute spinal cord injury.
abstract: OBJECTIVE
  Venous stasis and intrathecal hypertension are believed to play a significant role in the hypoperfusion present in the spinal cord following injury. Lowering the intrathecal pressure via cerebrospinal fluid (CSF) drainage has been effective in treating spinal cord ischemia during aorta surgery. The purpose of the present study was to determine whether CSF drainage increases spinal cord perfusion and improves outcome after spinal injury in an animal model.
  
  
  METHODS
  Anesthetized adult rabbits were subjected to a severe contusion spinal cord injury (SCI). Cerebrospinal fluid was then drained via a catheter to lower the intrathecal pressure by 10 mm Hg. Tissue perfusion was assessed at the site of injury, and values obtained before and after CSF drainage were compared. Two other cohorts of animals were subjected to SCI: 1 group subsequently underwent CSF drainage and the other did not. Results of histological analysis, motor evoked potential and motor function testing were compared between the 2 cohorts at 4 weeks postinjury.
  
  
  RESULTS
  Cerebrospinal fluid drainage led to no significant improvement in spinal cord tissue perfusion. Four weeks after injury, the animals that underwent CSF drainage demonstrated significantly smaller areas of tissue damage at the injury site. There were no differences in motor evoked potentials or motor score outcomes at 4 weeks postinjury.
  
  
  CONCLUSIONS
  Cerebrospinal fluid drainage effectively lowers intrathecal pressure and decreases the amount of tissue damage in an animal model of spinal cord injury. Further studies are needed to determine whether different draining regimens can improve motor or electrophysiological outcomes.
authors.affiliation: Department of Neurological Surgery, Indiana University College of Medicine, Indianapolis, IN 46202-5124, USA. emhorn@iupui.edu
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horn
authors.forename: Nicholas
authors.initials: N
authors.lastname: Theodore
authors.forename: Rachid
authors.initials: R
authors.lastname: Assina
authors.forename: Robert F
authors.initials: RF
authors.lastname: Spetzler
authors.forename: Volker K H
authors.initials: VK
authors.lastname: Sonntag
authors.forename: Mark C
authors.initials: MC
authors.lastname: Preul
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D002555:Cerebrospinal Fluid; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D004195:Disease Models, Animal; D004322:Drainage; D019054:Evoked Potentials, Motor; D007278:Injections, Spinal / Q000379:methods; D007796:Laminectomy / Q000379:methods; D010477:Perfusion / Q000379:methods*; D011817:Rabbits; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000628:therapy*