High Dose Steroids in Acute Spinal Cord Injury (ASCI)

Summary by Adam Lepkowsky MD, 04.04.22

High-dose methylprednisolone for acute traumatic spinal cord injury: A meta-analysis - https://pubmed.ncbi.nlm.nih.gov/31358617/
Take Home Point:

  • Ongoing debate on the use of high-dose ethylprednisolone early in ASCI.

  • Methylprednisolone was not associated with better motor or sensory recovery compared to no steroids.

  • High dose MP within 8 hours of ASCI is not recommended.

Management of Acute Traumatic Spinal Cord Injury: A Review of the Literature - https://pubmed.ncbi.nlm.nih.gov/34966774/

Take Home Point:

  • The authors do not believe there is consistent or compelling evidence to suggest high-dose methylprednisolone administration improves outcomes in TSCI based on current literature.

  • In fact, there is evidence to suggest it is associated with increased complications including infection, respiratory compromise, GI hemorrhage and death.

  • Therefore the authors do not recommend that methylprednisolone be used routinely in spinal cord injury patients.