RT Journal Article
SR Electronic
T1 Spinal Cord Hypothermia without Systemic Hypothermia
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A3175
A1 P.D. Purdy
A1 R.L. Novakovic
A1 B.P. Giles
A1 S.L. Miller
A1 M.S. Riegel
YR 2012
UL http://www.ajnr.org/content/early/2012/07/05/ajnr.A3175.abstract
AB BACKGROUND AND PURPOSE: Hypothermia has been shown to be beneficial in the setting of acute SCI. However, widespread use has been hindered by the need for systemic hypothermia as the vehicle for achieving spinal cord hypothermia. This study demonstrates that localized spinal cord hypothermia can be achieved via a percutaneous approach while maintaining systemic normothermia. MATERIALS AND METHODS: Five Yucatan swine underwent catheterization of the subarachnoid space and infusion of room temperature, chilled, and iced PL solutions into the cervical spinal canal, with drainage from the lumbar canal. Thermocouples were placed within the spinal cord and in the subarachnoid space and recorded during infusions and recovery from hypothermia. RESULTS: Results demonstrated that hypothermia as low as 16.8°C is feasible in the spinal cord with retention of systemic normothermia, with strong (r = 0.95) correlation between the spinal cord temperature and the CSF temperature. Degrees of cooling varied with flow rates and with infusate temperature. CONCLUSIONS: While the data are preliminary in a small group of animals, the ability to rapidly create a wide range of controlled spinal cord hypothermia while preserving normal body temperature warrants wider exploration. The study also indicates that further investigation of the hypothesis that CSF temperature monitoring may be an acceptable surrogate for direct spinal cord temperature monitoring should be pursued. Abbreviations IBiced saline bathPINpercutaneous intraspinal navigationPLPlasma-Lyte ASCIspinal cord injury