High-dose methylprednisolone prevents extensive sick leave after whiplash injury. A prospective, randomized, double-blind study.
METHODS
A prospective, randomized, double-blind study comparing high-dose methylprednisolone with placebo.


OBJECTIVE
To evaluate the efficacy of high-dose methylprednisolone when administered within 8 hours after whiplash injury.


BACKGROUND
Whiplash injury often results in chronic symptoms. The management of whiplash injuries is controversial, and pharmacologic therapy has received little evaluation. In recent reports, dysfunction of the central nervous system has been indicated in several cases. Methylprednisolone administered within 8 hours after the injury to patients with acute spinal cord injury has been demonstrated to improve the outcome. This procedure was also adopted in a randomized study of cases of whiplash injury in car accidents.


METHODS
Forty patients, 22 men and 18 women with a mean age of 35 years (range, 19-65), were included in the study, 20 in each of two groups. They were treated for whiplash injury, which they had sustained in car accidents. The patients were enrolled if their diagnoses were complete and treatment had begun within 8 hours after injury. Disabling symptoms severe enough to prevent the patient from returning to work, number of sick days before and after injury, and sick-leave profile after injury were used as parameters for the evaluation of the effects of the treatment. Baseline demographic data were controlled for when statistical analysis had been performed.


RESULTS
At the follow-up examination 6 months after initial treatment, there was a significant difference in disabling symptoms between the actively treated patients and the placebo group (P = 0.047), total number of sick days (P = 0.01), and sick-leave profile (P = 0.003).


CONCLUSIONS
The results of this study indicate that acute treatment with high-dose methylprednisolone may be beneficial in preventing extensive sick leave after whiplash injury. However, the number of patients studied was small, and therefore further prospective, controlled studies are needed.
Pettersson
K
K
Department of Orthopaedics, Umeå University, Sweden.
Toolanen
G
G
D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002574:Cervical Vertebrae / Q000293:injuries*; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D011446:Prospective Studies; D018582:Sick Leave; D014911:Whiplash Injuries / Q000209:etiology / Q000517:prevention & control*
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone