Value of normothermic perfusion, hypothermic perfusion, and durotomy in the treatment of experimental acute spinal cord trauma

Abstract

✓ Investigations were performed to determine the relative therapeutic value of local hypothermic perfusion, local normothermic perfusion, and durotomy in monkeys injured by circumferential compression of the spinal cord at T9–10. A new method of cord compression was used consisting of an inflatable Silastic cuff which was passed around the cord extradurally and inflated to either 350 or 400 mm Hg. At the lower compression force, both hypothermic and normothermic perfusion improved the neurological recovery compared to that in control animals. However, at the higher degree of compression only normothermic perfusion produced significantly better recovery. Durotomy was excluded as a contributing factor. The results indicate that normothermic perfusion is a better method of treatment and that the beneficial effect of hypothermic perfusion is probably due to the perfusion rather than the hypothermia. The mechanism by which perfusion exerts its beneficial effect is unknown, but it is suggested that dialysis of noxious substances from the injured cord may play a role.