Spinal cord injury and resultant lower body paralysis is the most devastating non fatal complication of surgery for coarctation of the aorta. It may relate to lack of adequate collateral artery formation and to duration of aortic cross clamp time during repair. It may be possible to identify patients at risk by monitoring spinal cord electrical activity during test cross clamping of the aorta. Loss of electrical activity may be a cause for abandoning the planned surgical technique. This complication occurs only during surgery and is not a long term risk.