Steroids for acute spinal cord injury
Methylprednisolone has been shown to enhance sustained neurologic recovery in a phase III randomised trial; findings replicated in a second trial. Therapy must be started within 8 hours of injury using an initial bolus of 30 mg/kg by IV for 15 minutes followed 45 minutes later by a continuous infusion of 5.4 mg/kg/hour for 24 hours. Further improvement in motor function recovery has been shown to occur when the maintenance therapy is extended for 48 hours. This is particularly evident when the initial bolus dose could only be administered 3 to 8 hours after injury.
Steroid treatment in the early hours after acute spinal cord injury (SCI) is aimed at reducing the extent of permanent paralysis during the rest of the patient’s life. This review assessed randomised trials of steroids for human acute SCI.
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