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.

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

Chinese Herbal Medicine in Treatment of Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 48 (07) ◽  
pp. 1593-1616
Author(s):  
Yang Zheng ◽  
Shangfeng Qi ◽  
Fengqing Wu ◽  
Jintao Hu ◽  
Ronglin Zhong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Chinese Herbal ◽  
Sensory Score ◽  
Cord Injury

Spinal cord injury (SCI) is a catastrophic disease associated with damaged neurological structures and has become a significant social and economic burden for the health care system and patients’ families. The use of Chinese Herbal Medicine (CHM) to treat SCI has been increasing in recent years. This meta-analysis aimed to investigate the effectiveness of CHM for patients with SCI. Therefore, we included randomized controlled trials (RCTs) of CHM for SCI in seven databases. A total of 26 studies involving 1961 participants were included in this study. No serious heterogeneity or publication bias was observed across each study. The results showed that significant improvements of the American Spinal Injury Association (ASIA)-grading improvement rate ([Formula: see text], [Formula: see text]), clinical effective rate ([Formula: see text], [Formula: see text]), ASIA motor score ([Formula: see text], [Formula: see text]), ASIA sensory score (total) ([Formula: see text], [Formula: see text]), ASIA sensory score (light touch) ([Formula: see text], [Formula: see text]), ASIA sensory score (pinprick) ([Formula: see text], [Formula: see text]), and activities of daily living (ADL) score ([Formula: see text], [Formula: see text]) in CHM group compared with the control group. Among the CHM groups, Buyang Huanwu decoction was the most frequently prescribed herbal formula, while Astragalus membranaceus was the most commonly used single herb. In addition, there were no serious and permanent adverse effects in the two groups. The methodological quality of the most included RCTs was poor and the quality of evidence for the main outcomes was from very low to moderate according to the GRADE system. Current evidence suggests that CHM is an effective and safe treatment for SCI and could be treated as a complementary and alternative option with few side effects. However, considering the low quality, small size, and high risk of the studies identified in this meta-analysis, higher methodological quality, rigorously designed RCTs with large sample sizes are needed to confirm the results.

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