Table 4

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study weaknesses
Braken MB et al, 1984¹ and 1985,² USA	330 patients with acute spinal injury	PRCT	Neurological outcome	No difference at 6 weeks, 6 months and 1 year.	No placebo. “High” dose is in fact quite low
	Methylprednisolone 100 mg v methylprednisolone 1000 mg		Adverse effects	Wound infection rate increased in steroid group (RR 3.6)
Braken MB et al, 1990³ and 1992,⁴ USA	487 patients with acute spinal injury	PRCT	Neurological outcome	No difference overall. Stratification revealed significant neurological improvements when methylprednisolone was given within 8 h	Much stratification of data with significant risk of type 1 error
	Methylprednisolone 30 mg/kg and 5.4 mg/kg/h for 24 h v naloxone 5.4 mg/kg and 4 mg/kg/h for 24 h v placebo		Adverse effects	No significant differences