SPINAL CORD INJURY-METHYLPREDNISOLONE

SUMMARY

1. There is level 3 evidence that beneficial (sensory and motor) effects at 6 weeks, 6 months and 1 year are seen (for both complete and incomplete injuries) when methylprednisolone is administered within 8 hours of injury.

2. Outcome is possibly worse at 1 year if the drug is started after 8 hrs from injury.

3. Patients who were excluded from the study: cauda equina syndrome, GSW to the spine, life-threatening morbidity, pregnancy, narcotic addiction, age < 13 years, patients on maintenance steroids.

4. Complications of high-dose steroids: sepsis, pneumonia, hyperglycaemia, acute corticosteroid myopathy.

Reference(s)

1. Bracken M B, Shepard M J, Collins WF, et al.: A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. N Engl J Med 322: 1405-11, 1990.

2. Bracken M B, Shepanl M J, Collins W F, et al.: Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data. J Neurosurg; 76: 23-31,1992.

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