INTRODUCTION
Paraplegia due to spinal cord injury (SCI) is a devastating complication of surgery of the thoracic aorta. In patients requiring aortic arch replacement, the frozen elephant trunk (FET) is becoming the preferred method to treat complex aortic pathologies in a single stage. However, the incidence of paraplegia following FET, either in patients with acute aortic dissection or chronic aneurysms is still a major concern1,2. Although lumbar cerebrospinal fluid drainage (CSFD) is one of the most frequently used techniques for prevention of paraplegia its role in spinal cord protection is difficult to ascertain from available studies. One of the major issues concerning CSFD relates to when it should be employed and whether alone or combined with other strategies3.
The present case demonstrates the effectiveness of immediate use of CSFD in reversing paraplegia after a FET for a chronic aortic aneurysm.