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Spinal cord injury can be explained with an ischemia-infarction model which results in local edema of the spinal cord, damaging its structure and leading to reversible or irreversible loss of its function. Perfusion of the spinal cord during aortic procedures can be enhanced by several adjuncts which have been described with a broad variety of evidence in their support. These adjuncts include systemic hypothermia, cerebrospinal fluid drainage, extracorporeal circulation and distal aortic perfusion, segmental arteries reimplantation, left subclavian artery revascularization, and staged aortic repair. The Authors here reviewed and discussed the role of such adjuncts in preventing spinal cord injury from occurring, pinpointing current evidence and outlining future perspectives.<\/jats:p>","DOI":"10.1177\/17085381221094411","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T12:49:01Z","timestamp":1651668541000},"page":"874-883","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Spinal cord protection in open and endovascular approaches to thoracoabdominal aortic aneurysms"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4689-3871","authenticated-orcid":false,"given":"Andrea","family":"Amabile","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, 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