Inamasu Joji, Nakamura Yoshiki, Ichikizaki Kiyoshi
Department of Neurosurgery, National Tokyo Medical Center, Higashigaoka 2-5-1, Meguro, Tokyo 152-8902, Japan.
J Neurol Sci. 2003 May 15;209(1-2):55-60. doi: 10.1016/s0022-510x(02)00463-x.
The use of induced hypothermia in the treatment of traumatic spinal cord injury (SCI) has been studied extensively between the 1960s and 1970s. Although the treatment showed some promise, it became less popular by the 1980s, mainly because of its adverse effects. However, a revival of hypothermia in the treatment of traumatic brain injury (TBI) in the last decade has encouraged neuroscientists to conduct experiments to reevaluate the potential benefits of hypothermia in traumatic SCI. All laboratory investigations studying the mechanisms of action and/or the efficacy of induced hypothermia in treating experimental traumatic SCI published in the last decade were reviewed. Although efficacy of hypothermia in improving functional outcome of mild to moderate traumatic SCI has been demonstrated, hypothermia may not be protective against severe traumatic SCI. At present, induced hypothermia has yet to be recognized or approved as a potential treatment having therapeutic value for traumatic SCI in humans. The continued search for a possible synergistic effect of induced hypothermia and pharmacological therapy may yield some promise. It has also been deduced from these laboratory studies that hyperthermia is deleterious and rigorous measures to prevent hyperthermia should be taken to minimize the propagation of secondary neuronal damage after traumatic SCI.
20世纪60年代至70年代期间，人们对诱导低温疗法治疗创伤性脊髓损伤（SCI）进行了广泛研究。尽管该疗法显示出一定的前景，但到20世纪80年代，它就不那么受欢迎了，主要是因为其副作用。然而，在过去十年中，低温疗法在创伤性脑损伤（TBI）治疗中的复兴促使神经科学家开展实验，重新评估低温疗法对创伤性SCI的潜在益处。本文回顾了过去十年中所有研究诱导低温疗法治疗实验性创伤性SCI的作用机制和/或疗效的实验室研究。尽管低温疗法在改善轻度至中度创伤性SCI功能结局方面的疗效已得到证实，但低温疗法可能对重度创伤性SCI没有保护作用。目前，诱导低温疗法尚未被认可或批准为对人类创伤性SCI具有治疗价值的潜在治疗方法。持续探索诱导低温疗法与药物治疗可能产生的协同效应或许会带来一些希望。从这些实验室研究中还可以推断出，高温是有害的，应采取严格措施预防高温，以尽量减少创伤性SCI后继发性神经元损伤的扩散。
