Objective: Following the aortic aneurysm repair surgery, ischemic spinal cord injury is a substantial complication which may lead to
paraplegia. This study aims to explore the protective effect of cilostazol, which is a phosphodiesterase type-3 inhibitor, against ischemic/reperfusion-induced spinal cord injury that is experimentally forged in medulla spinalis of rats.

Methods: A total of 24 rats were separated into three workgroups. The control group (n=8); the ischemic group (n=8), in which aortic clamping was performed without cilostazol administration; and finally the cilostazol-adminsistered group (n=8). Each mouse was subjected to induced ischemia for 45 min by clamping of the abdominal aorta. Afterwards, blood build up was provided by de-clamping. Serial assessments of motor and sensory functions of all rats were performed prior to the operation and, at 24 and 48 h of reperfusion, using the Tarlov and LeMay scores. Later on, spinal cord tissues were collected for histopathologic examination.

Results: Tarlov scores at postoperative hours 24 and 48 tend to be significantly higher in the cilostazol-treated group than in the non-treated ischemia group (3.13±0.64 versus 1.25±0.71, p=0.0029 for the 24th hour; 2.75±0.71 versus 0.38±0.52, p=0.0016 for the 48th hour). LeMay scores at postoperative hours 24 and 48 were as well significantly higher in the cilostazol-treated group than in the non-treated ischemia
group (9.13±1.13 versus 4.50±0.76, p=0.0018 for the 24th hour; 9.00±1.20 versus 3.75±0.89, p=0.0018 for the 48th hour). Histologic outcomes were strongly correlated to the neurologic outcomes.

Conclusion: These results suggest that pre-ischemia cilostazol treatment has a protective effect against ischemia/reperfusion-induced spinal cord injury.