Methylprednisolon bij traumatische dwarslaesie: voorlopig nog geen baten voor de patiënt

Ever since the publication in 1990 in The New England Journal of Medicine of a multicentre, randomised, double-blind, placebo-controlled trial on the efficacy of methylprednisolone (MP) in the treatment of acute, traumatic spinal cord injury, the advice is to administer MP as soon as possible to every patient presenting a traumatic spinal cord injury. This recommendation has been followed throughout the world, especially by traumatologists, and seems to be above criticism. However, the results of most cited studies, which have had a major influence on the treatment of patients with an acute, traumatic spinal cord lesion, show that the improvements in the neurological condition due to MP cannot be translated into a specific improvement in the functional status. Until it has been proven beyond reasonable doubt that MP can play a significant role in the treatment of these patients, we advise that MP should not be administered to a patient with acute, traumatic spinal cord injury, awaiting the results of more quantitative research. Such research is being performed by the Cochrane Brain and Spinal Cord Injury Group.