DNA damage and repair in human spinal cord following ischemia-reperfusion injury

Spinal cord ischemia leading to paraplegia is a rare, sporadic, but devastating complication of surgery on the thoracoabdominal aorta. Our patient, a 69-year-old man, succumbed from a stroke on the third hospital day following surgical repair. He also had bilateral leg paralysis. At autopsy done 4 h after death there were remarkable differences between the thoracic or normally perfused spinal cord and the lumbar potentially ischemia or reperfused spinal cord. The measurements of injury were small in the thoracic spinal cord and extensive in the lumbar spinal cord DNA D/R. Apoptotic cell numbers and apoptosis-related enzymes such as caspase-3 were increased in the lumbar spinal cord. These findings duplicated those we reported in the rabbit subjected to 30 min of aortic occlusion and reperfusion injury. This is the first report in humans documenting DNA oxidative injury and apoptosis in ischemia-reperfusion injury of the spinal cord.