Exploration of surgical blood pressure management and expected motor recovery in individuals with traumatic spinal cord injury

Spinal Cord, 2020 · DOI: 10.1038/s41393-019-0370-5 · Published: October 24, 2019

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

This study investigates how blood pressure management during surgery for spinal cord injury (SCI) affects motor recovery. The researchers analyzed data from 25 individuals with traumatic SCI, looking at the relationship between mean arterial blood pressure (MAP) during surgery and improvements in motor function after surgery and rehabilitation. The findings suggest that maintaining MAP within a specific range (70-94 mmHg) during surgery may be associated with better motor recovery in these patients.

Study Duration

May 2013 to September 2015

Participants

25 individuals with traumatic SCI

Evidence Level

Retrospective analysis

Key Findings

1
Increased time within an intraoperative MAP range (70–94 mmHg) was associated with ISNCSCI motor score improvement.
2
ISNCSCI motor scores increased 0.036 for each minute of exposure to the MAP range 70–94 mmHg during the operative procedure.
3
Blood pressure exposures above or below this range did not display a positive association with motor recovery.

Research Summary

This study explores the impact of intraoperative blood pressure management on motor recovery following spinal cord injury (SCI) during acute inpatient rehabilitation. The results suggest that maintaining a mean arterial pressure (MAP) between 70 and 94 mmHg during surgery may be associated with better motor recovery. The study also indicates that both hypotension and hypertension during surgery may negatively impact motor recovery in individuals with SCI.

Practical Implications

Blood Pressure Targets

The study supports the use of MAP goals during surgery to limit both hypotension and hypertension in patients with traumatic SCI.

Surgical Management

Maintaining MAP in the 70-94 mmHg range during surgical stabilization may enhance early motor recovery, regardless of the completeness of SCI.

Clinical Trials

The findings contribute to the ongoing debate about optimal blood pressure targets and inform the design of future clinical trials.

Study Limitations

1
Small sample size (n = 25)
2
Retrospective nature of the study
3
Blood pressure monitoring focused on data collected during spinal stabilization

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