title: Spinal cord injuries in older children: is there a role for high-dose methylprednisolone?
abstract: We present a retrospective case series of 15 children (aged 8-16 years) with blunt traumatic spinal cord injury who were treated with methylprednisolone as per the National Acute Spinal Cord Injury Study protocol. Of all patients, 12 (80%) were male. Causes were sports injuries (n = 9), motor vehicle crashes (n = 2), and falls (n = 4). Most injuries were nonskeletal (n = 14), and all patients had incomplete injury of the spinal cord. The most common location of tenderness was cervical (n = 7). Of the 15 patients, methylprednisolone was initiated within 3 hours in 13 patients and between 3 and 8 hours in 2 patients. All patients received the medication for 23 hours as per the National Acute Spinal Cord Injury Study protocol. Of the 15 patients, 13 recovered completely by 24 hours and were discharged with a diagnosis of spinal cord concussion. One patient had compression fracture of T5 and T3-T5 spinal contusion but no long-term neurological deficit. One patient was discharged with diagnosis of C1-C3 spinal cord contusion (by magnetic resonance imaging) and had partial recovery at 2 years after injury. All patients with a diagnosis of cord concussion had normal plain films of the spine and computed tomographic and magnetic resonance imaging findings. None of the patients had any associated major traumatic injuries to other organ systems. The high-dose steroid therapy did not result in any serious bacterial infections.
authors.affiliation: Department of Pediatric Emergency Medicine, Children's Hospital of Michigan, Detroit Medical Center, Detroit, MI 48201, USA. bhaw9ana@yahoo.com
authors.forename: Bhawana
authors.initials: B
authors.lastname: Arora
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Suresh
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001265:Athletic Injuries; D002574:Cervical Vertebrae; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D020127:Recovery of Function; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000517:prevention & control; D013119:Spinal Cord Injuries / Q000150:complications / Q000188:drug therapy*; D016103:Spinal Fractures / Q000150:complications; D013904:Thoracic Vertebrae / Q000293:injuries; D001750:Urinary Bladder, Neurogenic / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone