In this paper, the author reviews the problematic around the spinal cord ischemic disfunction that sometimes occurs following the surgical management of thoracic and thoracoabdominal aortic aneurysm. After an anatomical review of the spinal cord vascularization, the diverse pathogenic mechanisms involved are described together with its importance and clinical significance, as well as the multiple procedures, techniques and pharmacotherapy employed nowadays aimed at lowering the occurrence of this most dramatic complication of thoracic and thoracoabdominal aortic aneurysm repair.
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