A recommendation has been issued, warning against the use of steroids in acute spinal cord injury (SCI) the first 24 to 48 hours following injury, according to a recent news release. The release reports that the recommendation was made by the Joint Section on Disorders of the Spine and Peripheral Nerves of the Congress of Neurological Surgeons (CNS), and the American Association of Neurological Surgeons, and represents a change from the Section’s previously issued guidelines in 2002.
Appearing in the March 2013 issue of Neurosurgery, the new Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injuries reportedly contain 112 recommendations targeting on 22 topics related to the care, assessment, imaging, and treatment of patients with acute cervical spine and SCIs. The release notes that the use of steroids in acute cervical spine and SCIs was previously recommended with consideration to the risk/reward profile, as evaluated by the physician. According to the new recommendation, “Administration of methylprednisolone (MP) for the treatment of acute SCI is not recommended.”
The authors add that the standard’s revision not only stems from a lack of medical evidence supporting benefits of the drugs’ use in the clinical setting, but also reflects the report’s findings, which indicate strong evidence that, “high-dose steroids are associated with harmful side effects including death.”
Daniel K. Resnick, MD, professor of neurological surgery at the University of Wisconsin School of Medicine and Public Health, president-elect, CNS, states the authors have presented a compelling case demonstrating a, “greater propensity for such medication to harm rather than benefit patients with spinal cord injuries. Overall, this update of the Guidelines is an impressive accomplishment. It represents the ‘state of the literature’ with regard to the treatment of patients with cervical spine and spinal cord injuries and is a useful guide to help clinicians make important decisions in the care of these patients.”
The release notes that the new guideline will be addressed in-depth during three presentations at the 2013 CNS Annual Meeting, October 19 to 23, San Francisco.
Source: Congress of Neurological Surgeons