Circular details

Acute spinal cord injury and methylprednisolone

A statistically significant average improvement in the neurological outcome of acute spinal cord injuries of one grade of severity has been found in patients treated with high dose methylprednisolone in a five year trial of drug treatment of spinal injuries (New England Journal of Medicine, 17 May 1990).

As a result of this study, authorities on spinal cord injuries in Australia, including Dr Richard Vaughan, Director, Spinal Unit, Royal Perth Rehabilitation Hospital, are now advocating the early use of methylprednisolone in all patients who have acute spinal injuries. Administration of the drug must commence within 8 hours of injury and within this time should commence as soon as practicable. The dose and preferred route of administration are outlined on the accompanying drug protocol.

I would recommend that all regional hospitals maintain stocks of the drug and that the contents of this letter are drawn to the attention of medical practitioners who work at regional hospitals.

Early initiation of appropriate treatment in suspected spinal cord injury is crucial to optimising neurologic recovery. If you have any questions regarding treatment of suspected spinal cord injury please do not hesitate to call the spinal Unit of Royal Perth Rehabilitation Hospital on (09) 382 7283.

Dr Michael M. Daube
ACTING COMMISSIONER OF HEALTH
DEPARTMENT OF HEALTH