Study of functional recovery produced by delayed localized cooling after spinal cord injury in primates.

Abstract

N SPITE of the sophisticated advances in modern surgical therapy, the present day management of spinal cord trauma generally remains unsatisfactory. 6,~,:3 Current methods used in the treatment of spinal cord trauma consist of immobilization with skeletal traction, surgical decompression with or without incision of dural coverings, and immediate or delayed bony fusion to provide stabilization. Controversy even exists as to the merits of conservative treatment versus surgical decompression. s,'~,1'-1:~,1~,~7,:~~ Even among those favoring early laminectomy in patients displaying sensory-motor paralysis associated with a spinal fluid block, there is no unanimity of opinion whether the dura should be opened or left intact. In reviewing other approaches to the problem of spinal cord injury, we were impressed with some of the work relating to the protective effect of cold on brain. It has been shown that hypothermia will decrease the cerebral metabolic demand, reduce brain volume, bring about a reduction in the inflammatory response to brain injury, and allow the brain to tolerate extended periods of circulatory arrest? 4,1a-2u24,~'~,~'J,33 It has also been demonstrated that total body cooling to 30~ will protect the spinal cord of the dog during occlusion of the thoracic aorta? 5,16 Because of the accessibility of the injured segment of the spinal cord during surgical laminectomy, an attempt has been made to assess the practical advantages of direct