Re: Solu-Medrol and spinal cord insult

["Jeff Brosius" <reno316@hotmail.com>]

>While on the research topic, does anyone on ythe list know of studies that 
>shown a proven absence of benefit to the use of solumedrol drips in the 
>acute phase of spinal cord injury/insult treatment/transfer?
>

Sorry...this is not the way science works.  You can't prove a negative.  The 
scientific method dictates that one propose a theory, then find the proof 
that his/her theory is accurate.  In other words, if you feel that steroids 
for SCI are beneficial, then the burden of proof is on you to prove this, 
not on others to disprove it.  Lacking such proof, the intervention should 
not be done.

Contact Dr. Eric Frykberg in Jacksonville, FL.  He's current president of 
EAST and should be able to point you in the right direction.

FWIW, there is no data showing proof for penetrating injury, only blunt.  
And even that data is sketchy...see below.

Young W. "Methylprednisolone and spinal cord injury." J Neurosurg 2002 
Jan;96(1 Suppl):141-2.

Bracken MB. "Methylprednisolone and spinal cord injury." J Neurosurg 2002 
Jan;96(1 Suppl):140-1; discussion 142.  (Letter.)

Hurlbert RJ. "The role of steroids in acute spinal cord injury: an 
evidence-based analysis." Spine 2001 Dec 15;26(24 Suppl):S39-46.

Short D. "Is the role of steroids in acute spinal cord injury now resolved?" 
Curr Opin Neurol 2001 Dec;14(6):759-63.

Nesathurai S. "The role of methylprednisolone in acute spinal cord 
injuries." J Trauma 2001 Aug;51(2):421-3.

"Steroids and spinal cord injury: Revisiting the NASCIS 2 and NASCIS 3 
trials." Journal of Trauma-Injury Infection & Critical Care. Vol 45(6) (pp 
1088-1093), 1998.

Enjoy the reading...

------------
JRB

Jeff Brosius,
Paramedic, etc.
Atlanta, GA
www.prehospital-perspective.com
brosius@prehospital-perspective.com
"What we imagine is order is merely
the prevailing form of chaos."
-- Kerry Thornley


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