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.
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Acknowledgements
Funded by the UK Spinal Cord Injury Research Network (UKSCIRN; grant to MCP) and the Neurosciences Research Foundation (NRF), Royal College of Surgeons of England and the London Deanery (fellowships to MCW). MCP is funded by the Guthy Jackson Charitable Foundation. MC, ZF, PS and GV are funded by the National Institute of Health Research (Neuroscience Theme), Cambridge. We thank P. Rich, T. Jones, M. Crocker, T. Bishop, J. Barnard (St George’s), M. Belci (Stoke Mandeville), D. Choi (National Hospital for Neurology and Neurosurgery), K. Rezajooi (Royal National Orthopaedic), D. Bell, N. Thomas (King’s College) and N. Burr (lay person).
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Werndle, M.C. et al. (2016). Measurement of Intraspinal Pressure After Spinal Cord Injury: Technical Note from the Injured Spinal Cord Pressure Evaluation Study. In: Ang, BT. (eds) Intracranial Pressure and Brain Monitoring XV. Acta Neurochirurgica Supplement, vol 122. Springer, Cham. https://doi.org/10.1007/978-3-319-22533-3_64
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DOI: https://doi.org/10.1007/978-3-319-22533-3_64
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