Template:Acute spinal cord injury treatment: Difference between revisions

(Created page with "*Assess for stability **Cervical Spine Injuries **Thoracic and Lumbar Spinal Injuries *Consider intubation for pt w/ injury at C5 or above *Steroids are no longer reco...")
 
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*Assess for stability
*Consider intubation injuries at C5 or above
**[[Cervical Spine Injuries]]
*Steroids are no longer recommended (see below)
**[[Thoracic and Lumbar Spinal Injuries]]
*Surgical intervention for:
*Consider intubation for pt w/ injury at C5 or above
*Steroids are no longer recommended
*Complete lesion means absence of sensory and motor function below level of injury
**May be confused w/ spinal shock
*Surgical intervention indicated for:
**Progressive neurologic deficits
**Progressive neurologic deficits
**Spinal instability (see [[Spinal Column Injuries (Cervical)]])
**[[Unstable spine fractures]]


===Steroids===
===Steroids===
{{Quote|text="Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death."|sign=Pharmacological therapy for acute spinal cord injury.|source=Neurosurgery. 2013 Mar;72 Suppl 2:93-105<ref>Hurlbert RJ et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2013 Mar;72 Suppl 2:93-105 http://www.ncbi.nlm.nih.gov/pubmed/23417182</ref>}}
{{Quote|text="Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death."|sign=Pharmacological therapy for acute spinal cord injury.|source=Neurosurgery. 2013 Mar;72 Suppl 2:93-105<ref>Hurlbert RJ et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2013 Mar;72 Suppl 2:93-105 http://www.ncbi.nlm.nih.gov/pubmed/23417182</ref>}}

Revision as of 14:53, 4 February 2015

  • Consider intubation injuries at C5 or above
  • Steroids are no longer recommended (see below)
  • Surgical intervention for:

Steroids

"Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death."

—Pharmacological therapy for acute spinal cord injury., Neurosurgery. 2013 Mar;72 Suppl 2:93-105[1]
  1. ↑ Hurlbert RJ et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2013 Mar;72 Suppl 2:93-105 http://www.ncbi.nlm.nih.gov/pubmed/23417182
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