Abstract
Introduction: Methylprednisolone (MP) has long been regarded as a standard of care in the treatment of acute spinal cord injury (ASCI). However the protocols for treatment according to the National Acute Spinal Cord Injury Study- NASCIS II & III are questioned in numerous clinical studies. Aim: The aim of the current study is to provide a review of the literature regarding the basic science data behind the use of MP in the treatment of ASCI, the results from clinical studies in MP and surgical treatment of ASCI. Material and Methods: Review of the literature in PUBMED, regarding basic science, clinical data trials for the use of MP in ASCI and surgical treatment of ASCI. Results: The positive results regarding neurological outcome NASCIS II & III, are not replicated in other publications employing these protocols. There is growing evidence for serious side effects and complications after the use high dose MP in ASCI patients. On the other hand, there are convincing evidences from recent prospective trials that early surgery has a positive impact on neurological outcome. Conclusion: There are no convincing evidences, that the use of MP according to the NASCIS II & III protocol has a positive impact on the neurological outcome after ASCI. Early decompression (< 24 hours after ASCI) is associated with improved neurologic outcome.
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Schedule a callMore From: Journal of Neurological Surgery Part A: Central European Neurosurgery
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