Objective      To determine the effects of citicoline pretreatment on spinal cord ischemia-reperfusion (IR) injury in rats.       Methods      Seventy-two male SD rats weighing 210 to 250 g were randomly divided into 3 groups (

n

=24): sham operation group

ischemia-reperfusion injury group (group IR) and citicoline pretreatment group

(group citi). Every group was divided into 4 subgroups according to the time after reperfusion for 12

24

48 and 72 h respectively (

n

=6). After modified Zivin methods was used to establish model

Tarlov with modification was used for neurological function scores at the above mentioned time points

HE staining was employed for L

2-5

spinal cord pathological changes

TUNEL method for calculation apoptosis cells

and immunohistochemical assay for Bcl-2

Bax

caspase-9 expression. The ratio of Bcl-2 to Bax (Bcl-2/Bax) was calculated.       Results      Compared to Sham group

group IR and group citi showed significantly lower neurological function scores

obvious pathological injury

increased apoptotic nerve cells

enhanced expression of caspase-9

Bax and Bcl-2

and significantly lower Bcl-2/Bax ratio（

P

<

0.01）. However

citi pretreatment resulted in better outcomes in above items compared to group IR（

P

<

0.01）.       Conclusion      Citicoline pretreatment attenuates spinal cord IR injury

improves neurological function through up-regulating Bcl-2

down-regulating Bax and caspase-9

and thus reducing neuronal apoptosis.