Hyperthermic preconditioning protects against spinal cord ischemic injury

Background. Paraplegia can result from operations requiring transient occlusion of the descending thoracic aorta. The present study tested whether inducing hyperthermia in rats before aortic ischemia would be neuroprotective. Methods. Rats were randomly assigned to hyperthermic preconditioning (n = 27) or control (n = 32) groups. Eighteen hours before ischemia, the hyperthermic preconditioned rats were heated at 41°C for 15 minutes. Ten minutes of spinal ischemia were produced by balloon occlusion of the thoracic aorta. Neurologic performance scores were evaluated daily to 7 days after ischemia. The lumbar region of the spinal cord was removed for histologic grading. Results. The hyperthermic preconditioned animals had less permanent spinal cord injury compared with controls (29.6% versus 59.4%, p = 0.02), and the incidence of immediate paraplegia in the hyperthermic preconditioned group was significantly less than that in the control group (3.7% versus 28.1%, p = 0.03). Histologic scores correlated with the neurologic outcome at the time of sacrifice in rats with permanent spinal cord injury but not in those walking normally. Conclusions. We used a rat model of spinal cord ischemia and found that hyperthermic preconditioning before spinal cord ischemia resulted in improved clinical outcome.