Methylprednisolone treatment in acute spinal cord injury: the myth challenged through a structured analysis of published literature.
BACKGROUND
Methylprednisolone has evolved during the 1990s, through the results obtained from the National Acute Spinal Cord Injury Studies NASCIS II and III, as a standard treatment in acute spinal injury.


OBJECTIVE
To evaluate the scientific basic for the use of methylprednisolone in acute spinal cord injury.


METHODS
Systematic review of the accumulated literature.


METHODS
Critical evaluation of the data obtained in the NASCIS II and III studies plus other accumulated literature.


RESULTS
Analyses have been made on subgroups of the study populations, and the results were based on statistical artefacts. Furthermore, improved functional recovery shown by these studies was not clinically significant.


CONCLUSIONS
There is insufficient evidence to support the use of methylprednisolone as a standard treatment in acute spinal cord injury.
Sayer
Faisal T
FT
Department of Neurosurgery, Lund University Hospital, Lund 221 85, Sweden. Faisal.Sayer@neurokir.lu.se
Kronvall
Erik
E
Nilsson
Ola G
OG
D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use*; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000188:drug therapy*
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone