Use of methylprednisolone in acute spinal injury

OBJECTIVE: To obtain an appraisal for the use of methylprednisolone (MP) in the early management of acute spinal cord injury (SCI) in our health system and the attitude to its use.

METHODS: A printed questionnaire on MP in acute SCI was distributed to all major spinal and neurosurgical centers in Riyadh, Kingdom of Saudi Arabia between October and November 2001.

RESULTS: A total of 31 replies were collected for statistical analysis. There were 23 replies from doctors (74%) who see 5 or more cases of acute SCI per year. Sixteen doctors (53%) use MP in acute SCI (National Acute Spinal Cord Injury Studies [NASCIS] protocol) regularly, 11 (37%) use it occasionally and 3 (10%) never use it. The use of MP in acute SCI was suggested as a standard of care by 16%, recommended only by 48% and considered optional by 35%. In addition, a review of the literature on the results of the NASCIS I, II and III was conducted.

CONCLUSION: Our results confirm the diversities in clinical practice regarding the use of MP in acute SCI. They also raise the issue of the need for specialized centers in spinal trauma with a unified protocol for treatment throughout the Kingdom.