- Discussion:
-
methylprednisolone given as bolus of 30 mg / kg body wt
- followed by infusion at 5.4 mg / kg / hour for 23 hours;
- if given w/ in 8 hrs, benefit from
methylprednisolone was seen in patients whose injuries were initially
evaluated as neurologically complete, as well as in those believed to have
incomplete lesions;
-
excluded pts:
- patients who are more than 8 hours from injury (these patients may actually do worse w/ steroids);
- those w/ involvement of nerve root or cauda equina only;
- gunshot wounds (see
GSW to the Spine);
- life-threatening morbidity
- those who were pregnant
- under 13 years of age;
- addicted to narcotics
- receiving maintenance steroids for other reasons
- Note: upto 40% of spine injured patients who receive steroids can be expected to develop some GI bleeding;
- hence,
PUD prophylaxis is warrented
Original Articles:
A Randomized, Controlled Trial of Methylprednisolone or Naloxone in the Treatment of Acute Spinal-Cord Injury:
Results of the Second National Acute Spinal Cord Injury Study.
Potential Benefits of High-Dose Methylprednisolone in Acute Spinal Cord Injuries
