Paraplegia After Surgery For Abdominal Aortic Aneurysms

To the Editor.— In 1973, we reported two cases of paraplegia following the resection of aneurysms of the infrarenal abdominal aorta, and we were able to find reports of an additional 17 cases in the literature.1Since that time, this complication has occurred in another patient in our institution, and five separate, additional cases have been reported.2-5We have also received letters from surgeons throughout the country about paraplegia following aneurysm resection. This complication, although not mentioned in standard surgical textbooks, is more common than has been appreciated. The blood supply to the spinal cord is tenuous at best, coming from both the two-part anterior spinal arteries and the single posterior spinal artery.6All three vessels run the entire length of the spinal cord, but the anterior spinal artery is responsible for blood supply of the greater part of its cross section. It is variably reinforced by