Article

Local hypothermia in the treatment of spinal cord injuries

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Abstract

In 1968 Albin et al1 reported on the beneficial effects of spinal cord cooling as a treatment of spinal cord injury in experimental animals. Two groups of rhesus monkeys received identical spinal cord injuries, and 4 hours after injury one of the groups was treated by irrigating the traumatized cords with cold saline solution. The recovery in this group was dramatic when compared with the control group, in which virtually no recovery took place. The clinical application of this method was advised for the treatment of spinal cord injuries.

We have had the opportunity to treat seven patients with local hypothermia. Five patients had been in accidents, and signs of cord damage after operations for other conditions had developed in two patients.

Case reports

Case 1. A 13-year-old girl was admitted by the orthopaedic service for surgical correction of congenital idiopathic scoliosis (Fig. 1). Neurological examination was normal. A myelogram demonstrated a congenital bar on the right side in the T-4 to T-6 area (Fig. 2).

A Risser cast was applied, and 4 days later Harrington rods were inserted. The bar demonstrated on the myelogram was interrupted by an osteotomy, and a bone graft was done from T-3 to T-7. The patient became paraplegic postoperatively. The wound was reopened, and a large epidural hematoma was found. A decompressive laminectomy was performed, and the bone graft and Harrington rods were removed. Partial improvement occurred, but no further progress was observed after the 14th postoperative day. A second myelogram showed. . .


 

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