Spinal cord ischemia recovery after TAAA repair improves from 35% at 3 months to 63% at 24 months

This retrospective cohort study analyzed 218 patients who developed spinal cord ischemia after thoracoabdominal aortic aneurysm repair at a single tertiary aortic referral hospital. Patients were identified from 3,216 TAAA repairs performed between 2015 and 2023, with follow-up extending to 24 months. The primary outcome was time to favorable functional recovery, defined as a modified Rankin Scale score of 3 or less.

The study found that favorable recovery rates improved substantially over time. At 3 months postoperatively, only 35.3% of patients had achieved favorable recovery. By 24 months, this proportion increased to 63.1%, with a statistically significant trend toward improvement reported (specific p-value not provided). Secondary outcomes included recovery trajectories, mortality, and healthcare resource utilization, though specific results for these endpoints were not reported in the provided data.

Safety and tolerability data were not reported. Key limitations include the retrospective design, which introduces potential for selection bias and confounding, and the single-center setting, which may limit generalizability to other institutions or patient populations. The observational nature of the data means causation cannot be established between specific factors and recovery outcomes.

For clinical practice, these findings suggest that functional recovery after postoperative spinal cord ischemia may continue for up to two years, with many patients achieving meaningful improvement beyond the initial postoperative period. However, clinicians should interpret these results cautiously due to the study's methodological limitations and await prospective validation before applying them broadly to clinical decision-making.