Published in 2013, the joint CNS/AANS Guidelines for the first time discourage the use of steroids for traumatic spinal cord injury. This comes after a thorough review of existing evidence and a critical re-examination of the NASCIS-studies previously interpreted as favouring steroid use.
“In summary, there is no consistent or compelling medical evidence of any class to justify the administration of MP (Methylprednisolone ed.) for acute SCI. Both consistent and compelling Class I, II, and III medical evidence exists suggesting that high-dose MP administration is associated with a variety of complications including infection, respiratory compromise, GI hemorrhage, and death. MP should not be routinely used in the treatment of patients with acute SCI”
Read the whole chapter on pharmacological therapies for SCI here.
Also of interest is this editorial by Medscape Medical News, which sheds some light on the process leading up to the revision of recommendations and its attendant discussions. Requires registration with Medscape (free).