Journal article
Methylprednisolone or tirilazad mesylate administration after acute spinal cord injury: 1-year follow up: Results of the third National Acute Spinal Cord Injury Randomized Controlled Trial
Journal of neurosurgery, Vol.89(5), pp.699-706
11/1998
DOI: 10.3171/jns.1998.89.5.0699
PMID: 9817404
Abstract
Object. A randomized double-blind clinical trial was conducted to compare neurological and functional recovery and morbidity and mortality rates 1 year after acute spinal cord injury in patients who had received a standard 24-hour methylprednisolone regimen (24MP) with those in whom an identical MP regimen had been delivered for 48 hours (48MP) or those who had received a 48-hour tirilazad mesylate (48TM) regimen. Methods. Patients for whom treatment was initiated within 3 hours of injury showed equal neurological and functional recovery in all three treatment groups. Patients for whom treatment was delayed more than 3 hours experienced diminished motor function recovery in the 24MP group, but those in the 48MP group showed greater 1-year motor recovery (recovery scores of 13.7 and 19, respectively, p = 0.053). A greater percentage of patients improving three or more neurological grades was also observed in the 48MP group (p = 0.073). In general, patients treated with 48TM recovered equally when compared with those who received 24MP treatments. A corresponding recovery in self care and sphincter control was seen but was not statistically significant. Mortality and morbidity rates at 1 year were similar in all groups. Conclusions. For patients in whom MP therapy is initiated within 3 hours of injury, 24-hour maintenance is appropriate. Patients starting therapy 3 to 8 hours after injury should be maintained on the regimen for 48 hours unless there are complicating medical factors.
Details
- Title: Subtitle
- Methylprednisolone or tirilazad mesylate administration after acute spinal cord injury: 1-year follow up: Results of the third National Acute Spinal Cord Injury Randomized Controlled Trial
- Creators
- Michael B BrackenMary Jo ShepardTheodore R HolfordLinda Leo-SummersE. Francois AldrichMahmood FazlMichael G FehlingsDaniel L HerrPatrick W HitchonLawrence F MarshallRuss P NockelsValentine PascalePhanor L PerotJoseph PiepmeierVolker K. H SonntagFranklin WagnerJack E WilbergerH. Richard WinnWise Young
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.89(5), pp.699-706
- DOI
- 10.3171/jns.1998.89.5.0699
- PMID
- 9817404
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 11/1998
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery
- Record Identifier
- 9984040009202771
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