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The Use of Methylprednisolone in Acute Spinal Cord Injury: A Review of the Evidence, Controversies, and Recommendations

Breslin, Kristen MD*; Agrawal, Dewesh MD*†

doi: 10.1097/PEC.0b013e3182724434
CME Review Article

The use of methylprednisolone after acute spinal cord injury has been under discussion for more than 20 years. There is ongoing debate about the efficacy and clinical impact of methylprednisolone in recovery from spinal cord injury, and studies show considerable variability in practice patterns among surgeons. Consensus statements consider methylprednisolone as a treatment option for acute spinal cord injury, but not a standard of care based on available evidence. This review discusses the evidence from prospective trials of methylprednisolone in adults and teenagers after spinal cord injury, consensus statements on the use of methylprednisolone, and practice variability in North America and the United Kingdom over time.

Fellow (Breslin), *Division of Emergency Medicine and Director (Agrawal), †Pediatric Residency Program, Children’s National Medical Center, Washington, DC.

The authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Dr. Breslin has disclosed that the U.S. Food and Drug Administration has not approved the use of Methylprednisolone for the treatment of acute spinal cord injury as discussed in this article. Please consult the product’s labeling for approved information.

Reprints: Kristen Breslin, MD, Division of Emergency Medicine, Children’s National Medical Center, 111 Michigan Ave NW, Washington, DC 20010 (e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.