Use of methylprednisolone in patients with spinal cord trauma, current situation
Keywords:
Spinal Cord Trauma; Spinal Cord; Methylprednisolone; CorticosteroidsAbstract
Traumatic spinal cord injury (TSCI) refers to the injury caused by external physical impacts, which can generate contusion, laceration, massive compression and solid spinal cord injury. The incidence rates of TSCI vary from 13 to 220 per million population. The pathophysiological events that occur after the injury are classified into two phases, one immediately after the trauma (primary injury) and another that occurs days to months later (secondary injury). For the treatment of TSCI, several neuroprotective strategies are used, such as the use of methylprednisolone, control of mean arterial pressure, and surgical decompression, but the safety and effectiveness of new drugs and substances in the acute treatment of TSCI are currently being evaluated. patients with TSCI. More scientific publications are needed to provide more evidence for the use of these new strategies. The literature is analyzed in search of the pathophysiological foundations of the use of corticosteroids in Spinal Cord Trauma (SCI). The most relevant articles on the use of methylprednisolone in MRT are reviewed, and they are critically analyzed, both in their design and in the way of presenting their results. It follows that the use of high-dose methylprednisolone in Acute Spinal Cord Trauma should be used with caution, and being alert to possible complications.
Downloads
References
Aarabi, B., Olexa, J., Chryssikos, T., Galvagno, S. M., Hersh, D. S., Wessell, A., Sansur, C., Schwartzbauer, G., Crandall, K., & Shanmuganathan, K. (2019). Extent of spinal cord decompression in motor complete (American Spinal Injury Association Impairment Scale Grades A and B) traumatic spinal cord injury patients: post-operative magnetic resonance imaging analysis of standard operative approaches. Journal of Neurotrauma, 36(6), 862-876. https://www.liebertpub.com/doi/abs/10.1089/neu.2018.5834
Ahn, H., Singh, J., Nathens, A., MacDonald, R. D., Travers, A., Tallon, J., Fehlings, M. G., & Yee, A. (2011). Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. Journal of Neurotrauma, 28(8), 1341-1361. https://www.liebertpub.com/doi/abs/10.1089/neu.2009.1168
Ahuja, C. S., Martin, A. R., & Fehlings, M. (2016). Recent advances in managing a spinal cord injury secondary to trauma. F1000Research, 5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890313/
Ahuja, C. S., Schroeder, G. D., Vaccaro, A. R., & Fehlings, M. G. (2017). Spinal cord injury—what are the controversies? Journal of orthopaedic trauma, 31, S7-S13. https://journals.lww.com/jorthotrauma/Fulltext/2017/09004/Spinal_Cord_Injury_What_Are_the_Controversies_.2.aspx
ASIA (2019). American Spinal Injury Association https://asia-spinalinjury.org/wp-content/uploads/2019/11/International-Standards-Worksheet-Spanish-Final_10_28_2019.pdf
Burney, R. E., Waggoner, R., & Maynard, F. M. (1989). Stabilization of spinal injury for early transfer. The Journal of trauma, 29(11), 1497-1499. https://europepmc.org/article/med/2585560
Chi, J. H., Eichholz, K. M., Anderson, P. A., Arnold, P. M., Dailey, A. T., Dhall, S. S., Harrop, J. S., Hoh, D. J., Qureshi, S., & Rabb, C. H. (2019). Congress of Neurological Surgeons systematic review and evidence-based guidelines on the evaluation and treatment of patients with thoracolumbar spine trauma: novel surgical strategies. Neurosurgery, 84(1), E59-E62.
Choi, S. H., Sung, C.-h., Heo, D. R., Jeong, S.-Y., & Kang, C.-N. (2020). Incidence of acute spinal cord injury and associated complications of methylprednisolone therapy: a national population-based study in South Korea. Spinal Cord, 58(2), 232-237. https://www.nature.com/articles/s41393-019-0357-2
Evaniew, N., Noonan, V. K., Fallah, N., Kwon, B. K., Rivers, C. S., Ahn, H., Bailey, C. S., Christie, S. D., Fourney, D. R., & Hurlbert, R. J. (2015). Methylprednisolone for the treatment of patients with acute spinal cord injuries: a propensity score-matched cohort study from a Canadian multi-center spinal cord injury registry. Journal of Neurotrauma, 32(21), 1674-1683. https://www.liebertpub.com/doi/abs/10.1089/neu.2015.3963
Fehlings, M. G., Vaccaro, A., Wilson, J. R., Singh, A., W. Cadotte, D., Harrop, J. S., Aarabi, B., Shaffrey, C., Dvorak, M., & Fisher, C. (2012). Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PloS one, 7(2), e32037. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0032037
Fehlings, M. G., Wilson, J. R., Tetreault, L. A., Aarabi, B., Anderson, P., Arnold, P. M., Brodke, D. S., Burns, A. S., Chiba, K., & Dettori, J. R. (2017). A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the use of methylprednisolone sodium succinate. Global spine journal, 7(3_suppl), 203S-211S. https://journals.sagepub.com/doi/abs/10.1177/2192568217703085
Guerado, E., Bertrand, M. L., Cano, J. R., Cerván, A. M., & Galán, A. (2019). Damage control orthopaedics: State of the art. World journal of orthopedics, 10(1), 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354106/
Hachem, L. D., Ahuja, C. S., & Fehlings, M. G. (2017). Assessment and management of acute spinal cord injury: From point of injury to rehabilitation. The journal of spinal cord medicine, 40(6), 665-675. https://www.tandfonline.com/doi/abs/10.1080/10790268.2017.1329076
Hadley, M. N., Walters, B. C., Aarabi, B., Dhall, S. S., Gelb, D. E., Hurlbert, R. J., Rozzelle, C. J., Ryken, T. C., & Theodore, N. (2013). Clinical assessment following acute cervical spinal cord injury. Neurosurgery, 72(suppl_3), 40-53. https://academic.oup.com/neurosurgery/article-abstract/72/suppl_3/40/2557444
Kato, S., Murray, J.-C., Kwon, B. K., Schroeder, G. D., Vaccaro, A. R., & Fehlings, M. G. (2017). Does surgical intervention or timing of surgery have an effect on neurological recovery in the setting of a thoracolumbar burst fracture? Journal of orthopaedic trauma, 31, S38-S43. https://journals.lww.com/jorthotrauma/FullText/2017/09004/Does_Surgical_Intervention_or_Timing_of_Surgery.6.aspx
Lubelski, D., Tharin, S., Como, J. J., Steinmetz, M. P., Vallier, H., & Moore, T. (2017). Surgical timing for cervical and upper thoracic injuries in patients with polytrauma. Journal of Neurosurgery: Spine, 27(6), 633-637. https://thejns.org/downloadpdf/journals/j-neurosurg-spine/27/6/article-p633.pdf
Martin, A. R., Aleksanderek, I., & Fehlings, M. G. (2015). Diagnosis and acute management of spinal cord injury: current best practices and emerging therapies. Current Trauma Reports, 1(3), 169-181. https://link.springer.com/article/10.1007/s40719-015-0020-0
Matsumoto, T., Tamaki, T., Kawakami, M., Yoshida, M., Ando, M., & Yamada, H. (2001). Early complications of high-dose methylprednisolone sodium succinate treatment in the follow-up of acute cervical spinal cord injury. https://journals.lww.com/spinejournal/fulltext/2001/02150/early_complications_of_high_dose.20.aspx
O’Toole, J. E., Kaiser, M. G., Anderson, P. A., Arnold, P. M., Chi, J. H., Dailey, A. T., Dhall, S. S., Eichholz, K. M., Harrop, J. S., & Hoh, D. J. (2019). Congress of Neurological Surgeons systematic review and evidence-based guidelines on the evaluation and treatment of patients with thoracolumbar spine trauma: executive summary. Neurosurgery, 84(1), 2-6. https://academic.oup.com/neurosurgery/article-abstract/84/1/2/5091887
Pfeifer, R., Kalbas, Y., Coimbra, R., Leenen, L., Komadina, R., Hildebrand, F., Halvachizadeh, S., Akhtar, M., Peralta, R., & Fattori, L. (2020). Indications and interventions of damage control orthopedic surgeries: an expert opinion survey. European Journal of Trauma and Emergency Surgery, 1-12. https://link.springer.com/article/10.1007/s00068-020-01386-1
Piazza, M., & Schuster, J. (2017). Timing of surgery after spinal cord injury. Neurosurgery Clinics, 28(1), 31-39. https://www.neurosurgery.theclinics.com/article/S1042-3680(16)30048-1/abstract
Postigo, R. (2006). Metilprednisolona en el tratamiento del trauma raquimedular. Analisis de la evidencia. Rev Med Clin Condes, 17(1), 12-19. https://cursa.ihmc.us/rid=1355601407875_1290208845_43847/MetilprednisolonaEnElTratamientoDelTrauma.pdf
Raksin, P., Harrop, J. S., Anderson, P. A., Arnold, P. M., Chi, J. H., Dailey, A. T., Dhall, S. S., Eichholz, K. M., Hoh, D. J., & Qureshi, S. (2019). Congress of neurological surgeons systematic review and evidence-based guidelines on the evaluation and treatment of patients with thoracolumbar spine trauma: prophylaxis and treatment of thromboembolic events. Neurosurgery, 84(1), E39-E42. https://academic.oup.com/neurosurgery/article-abstract/84/1/E39/5091886
Ryken, T. C., Hadley, M. N., Walters, B. C., Aarabi, B., Dhall, S. S., Gelb, D. E., Hurlbert, R. J., Rozzelle, C. J., & Theodore, N. (2013). Radiographic assessment. Neurosurgery, 72(suppl_3), 54-72. https://academic.oup.com/neurosurgery/article-abstract/72/suppl_3/54/2557454
Ryken, T. C., Hurlbert, R. J., Hadley, M. N., Aarabi, B., Dhall, S. S., Gelb, D. E., Rozzelle, C. J., Theodore, N., & Walters, B. C. (2013). The acute cardiopulmonary management of patients with cervical spinal cord injuries. Neurosurgery, 72(suppl_3), 84-92. http://cache1.medsci.cn/webeditor/uploadfile/201307/20130702100128738.pdf
Sanli, I., Spoor, A., Muijs, S., & Öner, F. (2019). Less invasive surgery is feasible in the management of traumatic thoracolumbar fractures in isolated and polytrauma injury. International Journal of Spine Surgery, 13(6), 561-567. http://www.ijssurgery.com/content/13/6/561.abstract
van Middendorp, J. J., Goss, B., Urquhart, S., Atresh, S., Williams, R. P., & Schuetz, M. (2011). Diagnosis and prognosis of traumatic spinal cord injury. Global spine journal, 1(1), 001-007. https://journals.sagepub.com/doi/abs/10.1055/s-0031-1296049
Wilson, J. R., Forgione, N., & Fehlings, M. G. (2013). Emerging therapies for acute traumatic spinal cord injury. Cmaj, 185(6), 485-492. https://www.cmaj.ca/content/185/6/485.short
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Revista Científica Arbitrada Multidisciplinaria PENTACIENCIAS - ISSN 2806-5794.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
