For the first time, the Joint Section on Disorders of the Spine and Peripheral Nerves of the Congress of Neurological Surgeons (CNS) and the American Association of Neurological Surgeons issued a recommendation against the use of steroids in acute spinal cord injury in the first 24 to 48 hours after an injury is sustained. This represents a change from the Section’s previously issued guidelines in 2002. The new 2013 guidelines have the potential to drastically impact the standard of care recommended for spinal cord injury patients and were published in the March, 2013, issue of Neurosurgery, the peer-reviewed journal of the CNS. The guidelines contain 112 recommendations centered on 22 topics related to the care, assessment, imaging and treatment of patients with acute cervical spine and spinal cord injuries. The new recommendation states, “Administration of methylprednisolone (MP) for the treatment of acute SCI is not recommended.” The standard has been revised based on lack of medical evidence supporting benefits of this drug’ use in the clinical setting. In fact, the report’s findings indicate strong evidence “high-dose steroids are associated with harmful side effects including death.”
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