title: Measurement of Intraspinal Pressure After Spinal Cord Injury: Technical Note from the Injured Spinal Cord Pressure Evaluation Study.
abstract: Intracranial pressure (ICP) is routinely measured in patients with severe traumatic brain injury (TBI). We describe a novel technique that allowed us to monitor intraspinal pressure (ISP) at the injury site in 14 patients who had severe acute traumatic spinal cord injury (TSCI), analogous to monitoring ICP after brain injury. A Codman probe was inserted subdurally to measure the pressure of the injured spinal cord compressed against the surrounding dura. Our key finding is that it is feasible and safe to monitor ISP for up to a week in patients after TSCI, starting within 72 h of the injury. With practice, probe insertion and calibration take less than 10 min. The ISP signal characteristics after TSCI were similar to the ICP signal characteristics recorded after TBI. Importantly, there were no associated complications. Future studies are required to determine whether reducing ISP improves neurological outcome after severe TSCI.
authors.affiliation: Academic Neurosurgery Unit, St George's, University of London, London, UK.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Werndle
authors.affiliation: Academic Neurosurgery Unit, St George's, University of London, London, UK.
authors.forename: Samira
authors.initials: S
authors.lastname: Saadoun
authors.affiliation: Academic Neurosurgery Unit, St George's, University of London, London, UK.
authors.forename: Isaac
authors.initials: I
authors.lastname: Phang
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: Marek
authors.initials: M
authors.lastname: Czosnyka
authors.affiliation: Department of Neurosurgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Varsos
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Czosnyka
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Smielewski
authors.affiliation: National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: Ali
authors.initials: A
authors.lastname: Jamous
authors.affiliation: Academic Neurosurgery Unit, St George's, University of London, London, UK.
authors.forename: B Anthony
authors.initials: BA
authors.lastname: Bell
authors.affiliation: National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: Argyro
authors.initials: A
authors.lastname: Zoumprouli
authors.affiliation: Academic Neurosurgery Unit, St George's, University of London, London, UK. mpapadop@sgul.ac.uk.
authors.forename: Marios C
authors.initials: MC
authors.lastname: Papadopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D002574:Cervical Vertebrae / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D065289:Pedicle Screws; D011312:Pressure; D013116:Spinal Cord / Q000098:blood supply*; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery; D013123:Spinal Fusion; D013355:Subdural Space; D013904:Thoracic Vertebrae / Q000601:surgery; D055815:Young Adult
keywords: Monitoring; Perfusion pressure; Spinal cord injury