EFFECTIVENESS OF METHYLPREDNISOLONE IN THE ACUTE PHASE OF SPINAL CORD INJURIES - A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS

EFFECTIVENESS OF METHYLPREDNISOLONE IN THE ACUTE PHASE OF SPINAL CORD INJURIES - A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. Steroid therapy has been tested as a protector in spinal cord injury. Multicenter studies evaluating the methylprednisolone (MP) in post traumatic neurological recovery have shown promising results according to NASCIS. A large number of critical studies related to the NASCIS results have been published. Objective: To review literature related to use of methylprednisolone compared with placebo. Methods: This analysis added the average improvement achieved in groups of patients who used MP and placebo (PL) to the average scores of groups at baseline, before treatment, resulting in the final neurological outcome for both groups. Results: The motor score of the MP group was only 2.5 points higher than the PL in a one year follow-up. In neurologically intact patients, the total score is 70 points. Improvement in sensitive scores was also discrete (1.1 and 1.7 points for the pinprick and light touch respectively). A high rate of complications was observed in a group of patients about 60 years old who used MP. Conclusion: Differences in the clinical magnitude of benefit obtained (not confirmed by other studies) with the use of MP or PL are not significant, in comparison with the potential for complications when using methylprednisolone. [Rev Assoc Med Bras 2009, 55(6): 729 - 37]