Suresh Prashasth Belludi, Dhatt Sarvdeep Singh, Kumar Vishal, Salaria Amit Kumar, Neradi Deepak, Samra Tanvir, Jain Kajal
Department of Orthopaedics, JSS Medical College, Mysuru, India.
Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Spine Surg Relat Res. 2022 Feb 10;6(5):453-459. doi: 10.22603/ssrr.2021-0137. eCollection 2022 Sep 27.
This prospective randomized controlled study aimed to examine the role of modest systemic hypothermia in individuals with acute cervical spinal cord injury (SCI) regarding neurological improvement. Studies have shown that the application of hypothermia is safe and that it improves neurological outcomes in patients with traumatic spine injury. Hypothermia helps in decreasing a secondary damage to the cord.
Twenty cases of acute post-traumatic cervical SCI with AISA were selected and randomly divided into two treatment groups: Group A-Hypothermia with surgical decompression and stabilization; and Group B-Normothermia with surgical decompression and stabilization. American Spinal Injury Association (ASIA) motor and sensory scores were evaluated at presentation; post-surgery; and at a 2-week, 6-week, and 12-week follow-up.
At the final follow-up, the change in ASIA motor scores of Group A was 46 (11.5-70.5) and Group B 13 (4.5-58.0), whereas ASIA sensory scores were 118 (24.75-186.5) and 29 (15.25-124.0) in Group A and Group B, respectively. ASIA scores between the two groups were statistically significantly different at a 2-week follow-up (ASIA motor p=0.04, ASIA sensory p=0.006), showing early improvement in the hypothermia group. There was no significant difference between the two groups on further follow-up.
Hypothermia can be applied safely to subjects with acute SCI. Our study showed that hypothermia was beneficial in the early improvement of functional outcomes in acute cervical SCI.
这项前瞻性随机对照研究旨在探讨适度全身性低温对急性颈脊髓损伤（SCI）患者神经功能改善的作用。研究表明，低温治疗应用安全，可改善创伤性脊柱损伤患者的神经功能结局。低温有助于减少脊髓的继发性损伤。
选取20例创伤后急性颈脊髓损伤伴美国脊髓损伤协会（AISA）分级的患者，随机分为两个治疗组：A组——低温治疗联合手术减压与固定；B组——常温治疗联合手术减压与固定。在入院时、术后、以及2周、6周和12周随访时评估美国脊髓损伤协会（ASIA）运动和感觉评分。
在末次随访时，A组ASIA运动评分变化为46（11.5 - 70.5），B组为13（4.5 - 58.0）；A组和B组的ASIA感觉评分分别为118（24.75 - 186.5）和29（15.25 - 124.0）。两组间在2周随访时ASIA评分差异有统计学意义（ASIA运动评分p = 0.04，ASIA感觉评分p = 0.006），表明低温治疗组早期有改善。进一步随访时两组间无显著差异。
低温治疗可安全应用于急性脊髓损伤患者。我们的研究表明，低温治疗有利于急性颈脊髓损伤患者功能结局的早期改善。
