Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data: Results of the second National Acute Spinal Cord Injury Study

M. B. Bracken, M. J. Shepard, W. F. Collins, T. R. Holford, D. S. Baskin, H. M. Eisenberg, E. Flamm, L. Leo-Summers, J. C. Maroon, L. F. Marshall, P. L. Perot, J. Piepmeier, V. K.H. Sonntag, F. C. Wagner, J. L. Wilberger, H. R. Winn, W. Young

Research output: Contribution to journalArticle

592 Scopus citations

Abstract

The 1-year follow-up data of a multicenter randomized controlled trial of methylprednisolone (30 mg/kg bolus and 5.4 mg/kg/hr for 23 hours) or naloxone (5.4 mg/kg bolus and 4.0 mg/kg/hr for 23 hours) treatment for acute spinal cord injury are reported and compared with placebo results. In patients treated with methylprednisolone within 8 hours of injury, increased recovery of neurological function was seen at 6 weeks and at 6 months and continued to be observed 1 year after injury. For motor function, this difference was statistically significant (p = 0.030), and was found in patients with total sensory and motor loss in the emergency room (p = 0.019) and in those with some preservation of motor and sensory function (p = 0.024). Naloxone-treated patients did not show significantly greater recovery. Patients treated after 8 hours of injury recovered less motor function if receiving methylprednisolone (p = 0.08) or naloxone (p = 0.10) as compared with those given placebo. Complication and mortality rates were similar in either group of treated patients as compared with the placebo group. The authors conclude that treatment with the study dose of methylprednisolone is indicated for acute spinal cord trauma, but only if it can be started within 8 hours of injury.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalJournal of neurosurgery
Volume76
Issue number1
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

Keywords

  • acute spinal cord injury
  • methylprednisolone
  • naloxone
  • randomized clinical trial

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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