[Effectiveness of methylprednisolone in the acute phase of spinal cord injuries--a systematic review of randomized controlled trials].
Steroid therapy has been tested as a protector in spinal cord injury. Multicenter studies evaluating the methylprednisolone (MP) in post traumatic neurological recovery have shown promising results according to NASCIS. A large number of critical studies related to the NASCIS results have been published.


OBJECTIVE
To review literature related to use of methylprednisolone compared with placebo.


METHODS
This analysis added the average improvement achieved in groups of patients who used MP and placebo (PL) to the average scores of groups at baseline, before treatment, resulting in the final neurological outcome for both groups.


RESULTS
The motor score of the MP group was only 2.5 points higher than the PL in a one year follow-up. In neurologically intact patients, the total score is 70 points. Improvement in sensitive scores was also discrete (1.1 and 1.7 points for the pinprick and light touch respectively). A high rate of complications was observed in a group of patients about 60 years old who used MP.


CONCLUSIONS
Differences in the clinical magnitude of benefit obtained (not confirmed by other studies) with the use of MP or PL are not significant, in comparison with the potential for complications when using methylprednisolone.
Botelho
Ricardo Vieira
RV
Programa de pós-graduação em Ciências da Saúde, IAMSPE.
Daniel
Jefferson Walter
JW
Boulosa
José Luis Romeo
JL
Colli
Benedicto Oscar
BO
Farias
Ronald de Lucena
Rde L
Moraes
Osmar José Santos
OJ
Pimenta
Wilson Eloy
WE
Ribeiro
Carlos Henrique
CH
Ribeiro
Francisco Ricardo Borges
FR
Taricco
Mario Augusto
MA
Carvalho
Marcio Vinhal de
MV
Bernardo
Wanderley Marques
WM
D006801:Humans; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use*; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010919:Placebos / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013119:Spinal Cord Injuries / Q000188:drug therapy*
D018696:Neuroprotective Agents; D010919:Placebos; D008775:Methylprednisolone