Application of Modest Hypothermia in Patients with Acute Traumatic Cervical Spine Injury: A Pilot Study

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.