Objective To investigate any neuroprotective effect when tacrolimus postconditioning is combined with rehabilitation training after spinal cord ischemia-reperfusion injury.Methods Sixty male Sprague-Dawley rats were randomly divided into a tacrolimus postconditioning group,a rehabilitation training group,a sequential therapy group and a model control group.A model of spinal cord ischemia was prepared by means of catheterization through the femoral artery and balloon dilatation.The model control group underwent reperfusion 20 min after the spinal cord ischemia.The tacrolimus postconditioning and sequential therapy groups received a single injection of tacrolimus (0.5 mg/kg) through the left common carotid artery at the onset of reperfusion.The rehabilitation training and sequential therapy groups received rehabilitation training 1 d after reperfusion.Superoxide dismutase (SOD) activity and malondialdehyde (MDA) level were measured in spinal cord tissues using the xanthineoxidase and thiobarbituric acid (TBA) methods,respectively,2 d after reperfusion.The Basso,Beattie,and Bresnahan BBB scale was used to assess hindlimb locomotor function at 7,14 and 28 d after reperfusion.Histopathological changes in the spinal cord tissues were determined using hematoxylin eosin staining 7 d after reperfusion.Results SOD activity in the sequential therapy group was significantly higher than in the other three groups,and the average SOD activity of the tacrolimus postconditioning group was significantly higher than that of the rehabilitation training and model control groups 2d after reperfusion.The average MDA level of the sequential therapy group was significantly lower than those of the other three groups,with the MDA levels of the tacrolimus postconditioning and rehabilitation training groups significantly lower than that of the model control group 2 d after reperfusion.The locomotor function scores of the sequential therapy group were significantly superior to those of the tacrolimus postconditioning and rehabilitation training groups 14 and 28 d after reperfusion,and the average scores of the latter two groups were significantly higher than that of the model control group 7,14,and 28 d after reperfusion.The pathological changes in the spinal cord tissue of the sequential therapy group were not so serious as those observed in the tacrolimus postconditioning and rehabilitation training groups.The pathological changes of the control group were the most serious.Conclusion Tacrolimus postconditioning combined with rehabilitation training can exert a synergistic neuroprotective effect after spinal cord ischemiareperfusion injury,at least in rats.It can thus further inhibit lipid peroxidation and promote the recovery of locomotor function.