Questionnaire survey of spine surgeons on the use of methylprednisolone for acute spinal cord injury.
METHODS
A questionnaire survey.


OBJECTIVE
Estimate the use and justification of the steroid protocol for spinal cord injury (SCI) patients.


BACKGROUND
There remains significant debate over clinical benefits and potential complications of the steroid protocol for SCI patients.


METHODS
A survey was sent to spine surgeons requesting information on 1) specialization, 2) trauma center affiliation, 3) use of steroid protocol, 4) justification of using steroid protocol, and 5) SCI volume.


RESULTS
Responses were received from 305 surgeons. Fourteen (4.6%) surgeons used steroids only if initiated before their consult, 262 (85.9%) would initiate if within the accepted 8-hour timeframe, 20 (6.6%) did not use steroids at all, and 9 (3.0%) used a different protocol. Justification for steroids use: 65 improved recovery, 64 institutional protocol, 110 medicolegal reasons, and 26 did not personally initiate steroids. Eighteen surgeons listed both clinical benefit and institutional protocol, and 22 others listed both institutional protocol and medicolegal reasons.


CONCLUSIONS
The majority (90.5%) of responding surgeons used the steroid protocol; however, only 24.1% used the steroid protocol due to a belief in improved clinical outcomes.
Eck
Jason C
JC
Department of Orthopaedic Surgery, Memorial Hospital, York, PA 17403, USA. jason-laurie@suscom.net
Nachtigall
Dean
D
Humphreys
S Craig
SC
Hodges
Scott D
SD
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use*; D009656:North America; D009985:Orthopedics / Q000379:methods* / Q000592:standards; D011364:Professional Practice / Q000592:standards; D012955:Societies, Medical; D013119:Spinal Cord Injuries / Q000188:drug therapy*; D013131:Spine / Q000601:surgery*; D011795:Surveys and Questionnaires
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone