Although
hypothermia has shown to protect against ischemic and traumatic neuronal death, its potential role in neurologic recovery following traumatic
spinal cord injury (TSCI) remains incompletely understood. Herein, we systematically review the safety and efficacy of
hypothermia therapy for TSCI. The English medical literature was reviewed using
PRISMA guidelines to identify preclinical and clinical studies examining the safety and efficacy of
hypothermia following TSCI. Fifty-seven articles met full-text review criteria, of which twenty-eight were included. The main outcomes of interest were neurological recovery and postoperative complications. Among the 24 preclinical studies, both systemic and local
hypothermia significantly improved neurologic recovery. In aggregate, the 4 clinical studies enrolled 60 patients for treatment, with 35 receiving systemic
hypothermia and 25 local
hypothermia. The most frequent complications were respiratory in nature. No patients suffered neurologic deterioration because of
hypothermia treatment. Rates of American
Spinal Injury Association (AIS) grade conversion after systemic
hypothermia (35.5%) were higher when compared to multiple SCI database control studies (26.1%). However, no statistical conclusions could be drawn regarding the efficacy of
hypothermia in humans. These limited clinical trials show promise and suggest
therapeutic hypothermia to be safe in TSCI patients, though its effect on neurological recovery remains unclear. The preclinical literature supports the efficacy of
hypothermia after TSCI. Further clinical trials are warranted to conclusively determine the effects of
hypothermia on neurological recovery as well as the ideal means of administration necessary for achieving efficacy in TSCI.