{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T05:45:14Z","timestamp":1774849514187,"version":"3.50.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spinal cord ischemia (SCI) continues to be an in-depth complication of thoracoabdominal aortic aneurysm repair (TAAA); little is known about long-term outcomes, determinants of functional recovery, or comprehensive longitudinal data about this complication. However, both long-term functional pathways and the prognostic modifiable determinants after SCI are not well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedures<\/jats:title>\n                    <jats:p>A single-center, retrospective, cohort study was performed in a tertiary aortic referral hospital. Out of 3,216 TAAA repairs that had been done between 2015 and 2023, 218 patients (7.7%) with a documented postoperative SCI were the analytic cohort. The principle outcome was the time to favorable recovery, which was operationalized and measured as a modified Rankin Scale (mRS) score of \u22643. Independent predictors were identified by the use of multivariable Cox proportional-hazard and logistic regression models. The recovery trajectories, mortality, and utilization of health -care resources were estimated in a 24\u202fmonths period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The average age of the participants was 69.2\u202fyears old, with 58.3% of the total respondents being aged over 70\u202fyears. The favorable recovery rates improved to 35.3% at 3\u202fmonths to 63.1% at 24\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      -trend &amp;lt;0.001). On multivariable Cox analysis, incomplete SCI [adjusted hazard ratio (aHR) 3.85, 95% CI 2.45\u20136.05], endovascular repair (aHR 1.52, 95% CI 1.08\u20132.14), and use of cerebrospinal fluid drainage (aHR 2.44, 95% CI 1.61\u20133.70) were independently associated with a higher rate of achieving favorable functional recovery. Significant adverse predictors included advanced age, chronic kidney disease, Crawford type II aneurysm and duration of spinal ischaemia over 45\u202fmin (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). A clinical nomogram based on these variables showed an acceptable level of discriminative power (C- index\u202f=\u202f0.78). Patients who had achieved positive recovery had significantly better 5\u202fyears survival (68% vs. 18% log-rank,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and less health-care utilization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Functional recovery in the post-SCI period after TAAA repair is a long process up to 24\u202fmonths. The severity of the attack at the onset of the disease is the most critical prognostic variable; however, the interventions (endovascular intervention and drainage via the CSF) which can be controlled significantly improve the likelihood of recovery. Achievement of desirable functional outcome is closely linked with a high survival advantage thus demonstrating the critical significance of preventive measures, high surgical proficiency and long-term rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1793939","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T04:13:05Z","timestamp":1774843985000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term functional recovery and prognostic determinants of spinal cord ischemia post-thoracoabdominal aortic aneurysm repair: a population-based cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Bing","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, The Second Affiliated Hospital of Dalian Medical University","place":["Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyu","family":"Yan","sequence":"additional","affiliation":[{"name":"School of Public Health, China Medical University","place":["Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haitao","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Affiliated Hospital of Dalian Medical University","place":["Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Longyu","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Affiliated Hospital of Dalian Medical University","place":["Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bokai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Affiliated Hospital of Dalian Medical University","place":["Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Affiliated Hospital of Dalian Medical University","place":["Liaoning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"438","DOI":"10.21037\/acs-2023-scp-08","article-title":"Spinal cord protection for thoracoabdominal aortic aneurysm repair: from bench to bedside","volume":"12","author":"Carroll","year":"2023","journal-title":"Ann Cardiothorac Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.jvs.2020.07.107","article-title":"Spinal cord protection practices used during endovascular repair of complex aortic aneurysms by the U.S. aortic research consortium","volume":"73","author":"Aucoin","year":"2021","journal-title":"J 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