Consequences of high-dose steroid therapy for acute spinal cord injury

J Trauma. 1997 Feb;42(2):279-84. doi: 10.1097/00005373-199702000-00017.


Objective: High-dose Solu-Medrol (Upjohn, Kalamazoo, Mich) therapy has become standard care in the management of acute spinal cord injury (ASCI). This study attempts to define the adverse effects that Solu-Medrol therapy has on these patients.

Design: Retrospective review with historical control.

Materials and methods: From May 1990 to April 1994, all patients with ASCI admitted within 8 hours of injury received high-dose Solu-Medrol per the National Acute Spinal Injury Study (NASCIS-2) protocol. Their demographic and outcome parameters were compared with those of a group admitted from March 1986 to December 1993 with an associated ASCI who received no steroid therapy.

Measurements and main results: Steroid therapy was associated with a 2.6-fold increase in the incidence of pneumonia and an increase in ventilated and intensive care days. However, it was associated with a decrease in duration of rehabilitation and had no significant impact on other outcome parameters, including mortality.

Conclusions: Although the NASCIS-2 protocol may promote early infectious complications, it has no adverse impact on long-term outcome in patients with ASCIs.

MeSH terms

  • Accidents, Traffic
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use*
  • Humans
  • Male
  • Methylprednisolone Hemisuccinate / adverse effects
  • Methylprednisolone Hemisuccinate / therapeutic use*
  • Middle Aged
  • Multiple Trauma
  • Retrospective Studies
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / drug therapy*
  • Treatment Outcome
  • Wounds, Nonpenetrating


  • Glucocorticoids
  • Methylprednisolone Hemisuccinate