A Comparison between Therapeutic Effect of Granulocyte Colony-stimulating Factor and Methylprednisolone in Treatment of Patients with Acute Traumatic Spinal Cord Injury

Abstract

Background & Aim: Spinal cord injury (SCI) is one of the worst kinds of traumatic injuries with remarkable social and economic effects on communities. Methods & Materials/Patients: In this prospective randomized clinical trial, 122 patients with traumatic spinal cord injury were admitted to Poursina hospital within 48 h of injury to compare G-CSF and high-dose methylprednisolone as neuroprotective therapy. Results: In this study, 122 patients were studied out of which 62 patients were included in the granulociote colony-stimulating factor (G-CSF) group with a mean age of 40.4, and 60 patients in the methylprednisolone group with an average age of 40.10 years. 55 patients (45%) out of 122 patients were completely paralyzed (Grade AIS: A) and 67 (55%) were with incomplete spinal injury (Grade AIS: B, C, D). The average ASIA sensory scores in the two groups were similarly compared in the same time intervals, and p values were 0.7, 0.3, 0.2, and 0.1, respectively . They were not statistically significant. Conclusion: According to the results, the G-CSF was shown to be beneficial in average ASIA motor and sensory scores in the two groups of male patients at six months of onset of G-CSF treatment (p value=0.04) and average ASIA motor scores improvement in the falls subgroup patients also differed significantly within six months of onset of G-CSF treatment (p value=0.03). A multicentre prospective randomized clinical trial to compare the placebo effect with G-CSF protocol's treatment, and also assessment of the cost benefits of the common medical treatment versus G-CSF are n eeded.