Central Cord Syndrome Medication

Updated: May 07, 2018
  • Author: Michelle J Alpert, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
  • Print
Medication

Medication Summary

Despite initial enthusiasm for the use of methylprednisolone in the treatment of acute SCI, based on the results of the National Acute Spinal Cord Injury Study (NASCIS) II and III, further analysis of these studies’ results failed to adequately support the use of high-dose steroids to improve neurologic function. [32, 33]  In 2002, an expert panel from the American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) agreed that evidence supporting treatment standards and guidelines for methylprednisolone therapy in acute SCI was not sufficient. Even so, at that time the use of methylprednisolone for either 24 or 48 hours was a recommended option in cases of acute SCI. In 2013, however, the AANS/CNS came out with a level I recommendation against this treatment, since the US Food and Drug Administration (FDA) had not approved methylprednisolone for this application and because there was no class I or II evidence to support a clinical benefit. Furthermore, class I, II, and III evidence exists that high-dose steroids may be harmful to the patient. [34, 35, 36, 37] Needless to say, there remains an ongoing debate within the clinical community regarding the use of high-dose methylprednisolone in the treatment of acute SCI, but high-dose infusions within the first 8 hours postinjury are no longer the standard of care.