Consequences of High-Dose Steroid Therapy for Acute Spinal Cord Injury

1997 ◽  
Vol 42 (2) ◽  
pp. 279-284 ◽  
Author(s):  
S. J. Gerndt ◽  
J. L. Rodriguez ◽  
J. W. Pawlik ◽  
P. A. Taheri ◽  
W. L. Wahl ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Steroid Therapy ◽  
Acute Spinal Cord Injury ◽  
High Dose ◽  
High Dose Steroid ◽  
Cord Injury

scholarly journals High-dose methylprednisolone may cause myopathy in acute spinal cord injury patients

Spinal Cord ◽  
2004 ◽  
Vol 43 (4) ◽  
pp. 199-203 ◽  
Author(s):  
T Qian ◽  
X Guo ◽  
A D Levi ◽  
S Vanni ◽  
R T Shebert ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Acute Spinal Cord Injury ◽  
High Dose ◽  
High Dose Methylprednisolone ◽  
Cord Injury

High-Dose Steroid Therapy Offers Improvement in Spinal Cord Injuries

1993 ◽  
Vol 4 (3) ◽  
pp. 566-572
Author(s):  
Myra F. Ellis
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Steroid Therapy ◽  
Nursing Care ◽  
Spinal Cord Injuries ◽  
Mechanisms Of Action ◽  
High Dose ◽  
Cord Injury ◽  
Neurologic Function ◽  
Made In

A spinal-cord injury can alter every aspect of a victim’s life. Despite continued improvements in mortality associated with a spinal-cord injury, until recently little progress had been made in improving neurologic function. This paper reviews the development of steroid therapy for spinal cord injuries, the mechanisms of action, and the nursing care associated with its use

scholarly journals A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Use of Methylprednisolone Sodium Succinate

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 203S-211S ◽  
Author(s):  
Michael G. Fehlings ◽  
Jefferson R. Wilson ◽  
Lindsay A. Tetreault ◽  
Bizhan Aarabi ◽  
Paul Anderson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Practice ◽  
Sodium Succinate ◽  
Acute Spinal Cord Injury ◽  
Adult Patients ◽  
High Dose ◽  
Methylprednisolone Sodium Succinate ◽  
Cord Injury

Introduction: The objective of this guideline is to outline the appropriate use of methylprednisolone sodium succinate (MPSS) in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MPSS in acute SCI. A multidisciplinary Guideline Development Group used this information, in combination with their clinical expertise, to develop recommendations for the use of MPSS. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: The main conclusions from the systematic review included the following: (1) there were no differences in motor score change at any time point in patients treated with MPSS compared to those not receiving steroids; (2) when MPSS was administered within 8 hours of injury, pooled results at 6- and 12-months indicated modest improvements in mean motor scores in the MPSS group compared with the control group; and (3) there was no statistical difference between treatment groups in the risk of complications. Our recommendations were: (1) “We suggest not offering a 24-hour infusion of high-dose MPSS to adult patients who present after 8 hours with acute SCI”; (2) “We suggest a 24-hour infusion of high-dose MPSS be offered to adult patients within 8 hours of acute SCI as a treatment option”; and (3) “We suggest not offering a 48-hour infusion of high-dose MPSS to adult patients with acute SCI.” Conclusions: These guidelines should be implemented into clinical practice to improve outcomes and reduce morbidity in SCI patients.

scholarly journals Administration of High-Dose Methylprednisolone Worsens Bone Loss after Acute Spinal Cord Injury in Rats

2021 ◽  
Vol 2 (1) ◽  
pp. 592-602
Author(s):  
Yuanzhen Peng ◽  
Wei Zhao ◽  
Yizhong Hu ◽  
X. Edward Guo ◽  
Jun Wang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bone Loss ◽  
Acute Spinal Cord Injury ◽  
High Dose ◽  
High Dose Methylprednisolone ◽  
Cord Injury

scholarly journals Serum cystatin C is increased in acute spinal cord injury: a multicentre retrospective study

Spinal Cord ◽  
2019 ◽  
Vol 58 (3) ◽  
pp. 341-347
Author(s):  
JinYuan Zhang ◽  
RuoTing Ding ◽  
QingZhang Xian ◽  
ZhiKun Wang ◽  
ZhongYuan Liu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Retrospective Study ◽  
Cystatin C ◽  
Steroid Therapy ◽  
Acute Spinal Cord Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Cord Injury ◽  
Multicentre Retrospective Study

Abstract Study design A multicentre retrospective study. Objective A multicentre retrospective study was performed to observe the changes in serum cystatin C (CysC) levels in patients with acute spinal cord injury (SCI). Setting Four hospitals in China. Methods Over a 5-year study period, the CysC, creatinine (Cr), and blood urea nitrogen (BUN) levels of people who had incurred SCI in the preceding 7 days were collected and compared with those of people with limb fracture (LF) who were matched for injury time and gender. People with SCI also were grouped by injury duration, ASIA Impairment Scale (AIS) grade and the presence or absence of steroid therapy and compared each day. Results Three hundred and twenty-three samples from people with SCI were retrospectively collected; their mean serum CysC levels were significantly higher than those of people with LF (p < 0.001); No significant difference was observed in Cr or BUN levels between the two groups (p > 0.14). CysC levels increased on the second day, peaked on day 3, and returned to normal on day 5. The more severely injured individuals had higher CysC levels. Steroid therapy or not had no influence for CysC levels. Conclusion CysC levels are increased in patients with acute SCI, possibly as a direct result of injury. Serum CysC is a potential biomarker of SCI.

scholarly journals Meta-analysis of the Effectiveness of Steroid Pulse Therapy in Treating Patients with Spinal Cord Injury

2021 ◽  
Vol 15 (1) ◽  
pp. 186-194
Author(s):  
Sanghee Kim
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Steroid Injection ◽  
Meta Analysis ◽  
Pulse Therapy ◽  
Controlled Trials ◽  
High Dose ◽  
Steroid Pulse ◽  
High Dose Steroid ◽  
Cord Injury

Background: High-dose steroid injection therapy is effective in reducing anti-inflammation and edema and is often used to treat patients with acute spinal cord injury. To evaluate the effectiveness of steroid pulse therapy and identify the factors that affect its effectiveness in patients with acute traumatic spinal cord injury. Methods: A comprehensive literature search of the databases Pubmed, Medline, the Cochrane Central Register of Controlled Trials, Embase, and CINAHL was performed on July 31, 2019, with no language and time limits. For analysis, studies conducted within the last 10 years were included to reflect on the recent trend. Results: A total of 3 randomized controlled trials and 5 observational studies with 2418 patients were included in this meta-analysis. High-dose steroid injection therapy was found to have a high effect on patients with acute spinal cord injury. The following factors had a strong influence on the effectiveness of high-dose steroid treatment in patients with acute spinal cord injuries: injury, onset ASIA, onset neurological assessment scales, time to start treatment after injury, age, BMI, and gender. Conclusion: It is necessary to accurately assess the scope of spinal injury in the early stages and actively provide nursing interventions to identify and mediate factors affecting the treatment effect.

High-dose methylprednisolone for acute traumatic spinal cord injury

Neurology ◽  
2019 ◽  
Vol 93 (9) ◽  
pp. e841-e850 ◽  
Author(s):  
Zhongyu Liu ◽  
Yang Yang ◽  
Lei He ◽  
Mao Pang ◽  
Chunxiao Luo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Events ◽  
Observational Studies ◽  
Hospital Costs ◽  
Acute Spinal Cord Injury ◽  
Current Evidence ◽  
High Dose ◽  
High Dose Methylprednisolone ◽  
Cord Injury

ObjectiveDue to the continuing debates on the utility of high-dose methylprednisolone (MP) early after acute spinal cord injury (ASCI), we aimed to evaluate the therapeutic and adverse effects of high-dose MP according to the second National Acute Spinal Cord Injury Study (NASCIS-2) dosing protocol in comparison to no steroids in patients with ASCI by performing a meta-analysis on the basis of the current available clinical trials.MethodsWe searched PubMed and Cochrane Library (to May 22, 2018) for studies comparing neurologic recoveries, adverse events, and in-hospital costs between ASCI patients who underwent high-dose MP treatment or not. Data were synthesized with corresponding statistical models according to the degree of heterogeneity.ResultsWe enrolled 16 studies (1,863 participants) including 3 randomized controlled trials (RCTs) and 13 observational studies. Pooled results indicated that MP was not associated with an increase in motor score improvement (RCTs: p = 0.84; observational studies: p = 0.44) and incidence of recovery by at least one grade on the American Spinal Injury Association Impairment Scale or Frankel (p = 0.53). Meanwhile, MP did not lead to better sensory recovery (p = 0.07). However, MP was associated with a significantly higher incidence of gastrointestinal hemorrhage (p = 0.04) and respiratory tract infection (p = 0.01). The difference in the overall in-hospital costs between MP and control groups was not statistically significant (p = 0.78).ConclusionsBased on the current evidence, high-dose MP treatment, in comparison to controls, does not contribute to better neurologic recoveries but may increase the risk of adverse events in patients with ASCI. Therefore, we recommend against routine use of high-dose MP early after ASCI.

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