Template:Acute spinal cord injury treatment

Acute Management of Spinal Cord Injury

• Consider intubation injuries at C5 or above
• Neurogenic shock management
• Consider surgical intervention for:
  • Progressive neurologic deficits
  • Unstable spine fractures
• Steroids are no longer recommended
  • 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.
  • See EBQ:High Dose Steroids in Cord Injury for further discussion