Abstract
Objective:To evaluate the clinical efficacy and safety of intermittent injection of methylprednisolone sodium succinate in the treatment of cervical spinal cord injury complicated with incomplete paraplegia.Methods:Seventy-eight patients with cervical spinal cord injury complicated with incomplete paraplegia who were admitted between August 2016 and December 2017 were enrolled and grouped into an observation group and a control group using random number table, 39 in each group. Patients in the control group were given vertebral body decompression and bone grafting and internal fixation according to the severity of spinal cord compression, while patients in the observation group were treated by methylprednisolone sodium succinate in addition to the same treatment as the control group. The clinical efficacy and medicine associated adverse reactions were compared between the two groups.Results:The cure rate of the observation group was significantly higher than that of the control group (46.2% (18/39) vs. 20.5% (8/39)). After the treatment, the Japanese Orthopaedic Association (JOA) score and American Spinal Cord Injury Association (ASIA) score of the two groups after treatment were significantly higher compared to before treatment, and the scores of the observation group were much higher than those of the control group (P<0.05). The incidence of adverse reactions of the observation and control groups was 15.4% and 17.9% respectively, and the difference was not statistically significant (P>0.05).Conclusion:Intermittent injection of methylprednisolone sodium succinate has definite efficacy in treating cervical spinal cord injury complicated with incomplete paraplegia, with a low incidence of adverse reactions; hence it is worth promotion.
Highlights
Cervical spinal cord injury may lead to complete paralysis and incomplete paralysis; about 50 among one million people have cervical spinal cord injury every year, and 90% of them die on the way to hospital, suggesting a high fatality rate.[1]
Cervical spinal cord injury includes primary injury, and secondary injury induced by local inflammatory reaction, hormone induced edema and systemic inflammatory reaction after injury.[5]
According to relevant clinical experience and literature,[6,7] the treatment schemes for cervical spinal cord injury complicated with incomplete paralysis mainly focused on secondary injury because primary injury is featured by sudden onset and rapid progress
Summary
Cervical spinal cord injury may lead to complete paralysis and incomplete paralysis; about 50 among one million people have cervical spinal cord injury every year, and 90% of them die on the way to hospital, suggesting a high fatality rate.[1]. Pak J Med Sci January - February 2019 Vol 35 No 1 www.pjms.org.pk 141 been increasing year by year, which has a serious impact on quality of life of surviving patients.[4] Cervical spinal cord injury includes primary injury, and secondary injury induced by local inflammatory reaction, hormone induced edema and systemic inflammatory reaction after injury.[5] According to relevant clinical experience and literature,[6,7] the treatment schemes for cervical spinal cord injury complicated with incomplete paralysis mainly focused on secondary injury because primary injury is featured by sudden onset and rapid progress. Whether adrenocortical hormone can be used in the treatment of cervical spinal cord injury and how to use it has become controversial.[8,9] One of the recent experimental study showed that the early use of high-dose glucocorticoids after cervical spine fracture combined with spinal cord injury could reduce or delay secondary injury and improve the prognosis.[10]
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