Hypothermia in the course of acute traumatic spinal cord injury

In this review we briefly discuss animal experiments involving acute traumatic spinal cord injury (SCI) and the need for larger animals in testing experimental therapies. This literature overview, including the discussion of our own results from animal models, examines the use of hypothermia as a treatment method for SCI. Finally, we report the results of hypothermia application in clinical trials. Minipigs have been proposed as a potentially preferable model to rodents (typically rats) for predicting outcomes in human SCI due to their closer anatomical similarity to humans. In various animal studies, hypothermic treatment applied in the acute phase after SCI has resulted in neuroprotective effects, most likely due to inhibition of blood flow and oxygen consumption and reduction of overall metabolic activity and inflammation, resulting in improved nerve tissue sparing. Small‑scale human clinical trials have been carried out, involving general (whole‑body, systemic) or local hypothermia (close to the SCI site), with encouraging results. Nevertheless, further multi‑center, randomized, double‑blind studies with much larger patient numbers are necessary so that protocols can be standardized in order for hypothermia treatment to be reliably applied in clinical practice .