Clinical care and evolution of paraplegic monkeys (Macaca mulatta) over fourteen months post-lesion.

We have generated a non-human primate model of complete spinal cord injury (SCI) with a protracted survival time. Two adult Macaca mulatta underwent complete spinal cord transection at T8-T9. We report the effective daily care protocol for over one year survival, the health problems we encountered and the treatments applied. The animals' cages were customized to maintain them in the best possible condition when paraplegic. Daily care, adapted from human care protocols, focused mainly on urinary bladder and skin care, and lower limb rehabilitation. The most important health problems we faced were skin lesions, in particular from self-injury to insensitive regions, and urine voiding dysfunction. Skin lesions were chronic and severe in one of the monkeys. Serious voiding dysfunction occurred temporarily in one monkey in parallel with a high dose oxcarbazepine treatment. The main musculoskeletal complications were vertebral column deformities, which appeared in both monkeys. The rich experience gathered over the lengthy survival period of the two adult paraplegic macaques, the longest to date in the literature, should be useful for other scientists willing to study the long term physiopathological changes that follow SCI as well as the effects of diverse therapeutic strategies before they are applied to humans.