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  • Worldwide steroid prescription for acute spinal cord injury

    Final Number:

    Asdrubal Falavigna PhD; Francine W Quadros; Alisson R Teles MD; Chung Chek Wong; Giuseppe Barbagallo MD; Darrel S. Brodke MD; Abdulaziz Al-Mutair; K Daniel Riew MD

    Study Design:

    Subject Category:

    Meeting: Section on Disorders of the Spine and Peripheral Nerves Spine Summit 2018

    Introduction: There has always been great interest in discovering effective treatments for spinal cord injury (SCI), since it is a debilitating pathology with considerable socioeconomic consequences. Over the years, publications involving the use of methylprednisolone (MP) after acute SCI have described conflicting results. While some papers demonstrated efficacy others showed no benefits. The worldwide overview on the use of MP, its reasons, and beliefs of different regions will provide a guide for educational activities.

    Methods: English version of a previously published questionnaire were used to evaluate opinions about MP administration in acute SCI in LA, EU, AP, NA, and ME. This internet-based survey was conducted by members of AOSpine. The questionnaire asked about demographic features, background with management of spine trauma patients, routine administration of MP in acute SCI and reasons for MP administration.

    Results: A total of 2,659 responses were obtained for the electronic questionnaire from LA, EU, AP, NA, and ME. The number of spine surgeons that treat SCI was 2,206 (83%). The steroid was used by 1,198 (52.9%) surgeons. The uses of MP were based predominantly on the National Acute Spinal Cord Injury Study (NASCIS) III study (n=595, 50%). The answers were most frequently given by spine surgeons from AP, ME, and LA. These regions presented a statistically significant difference from North America (p<0.001). The number of SCI patients treated per year inversely influenced the use of MP. The higher the number of patients treated, the lower the administration rates of MP were observed.

    Conclusions: The study identified potential targets for educational campaigns, aiming to reduce inappropriate practices of MP administration.

    Patient Care: This study aimed to indentify the reasons that lead spine surgeons to keep on prescribing steroids in acute SCI. Hence, it will be possible to create educative programs in order to reduce the wrong use of steroids in this setting.

    Learning Objectives: To continue the line of the previous publication using steroid for acute spinal cord injury (SCI) by spine surgeon from Latin America (LA) and assess the current status of methylprednisolone (MP) prescription in Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) to determine targets for educational activities suitable for each region.


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