© 2000 the Emergency Medicine Journal
Best evidence topic report
Corticosteroids in acute spinal cord injury
Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Report by Paul Wallman, Clinical Fellow Search checked by Kevin Mackway-Jones, Consultant
A 40 year old man is involved in a road traffic accident. He has bony disruption at C7/T1 with acute spinal cord injury. He has no associated head injury and no other life threatening injuries. You wonder whether he should be given high dose corticosteroids for his cord injury.
In [patients with acute traumatic spinal cord injury] do [high dose corticosteroids] improve [neurological outcome]?
Medline 1966–01/00 using the OVID interface. [({exp spinal injuries OR spinal injury.mp OR spinal injuries.mp} AND {exp acute disease OR acute.mp}) OR acute spinal injury.mp OR acute spinal injuries.mp] AND maximally sensitive RCT filter LIMIT to human AND english.
Altogether 245 papers were found of which 241 were irrelevant or of insufficient quality. The remaining four papers are shown in table 4
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View this table: [in a new window] Table 4 |
No study has shown a benefit of corticosteroids in unselected patients. Stratification of data in NASCIS 2 has shown a subgroup of patients
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This article has been cited by other articles:
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Frampton, A E, Eynon, C A
(2006). High dose methylprednisolone in the immediate management of acute, blunt spinal cord injury: what is the current practice in emergency departments, spinal units, and neurosurgical units in the UK?. Emerg. Med. J.
23: 550-553
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