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dc.contributor.authorFehlings, M.G.
dc.contributor.authorWilson, J.R.
dc.contributor.authorTetreault, L.A.
dc.date.accessioned2019-07-15T16:12:09Z
dc.date.available2019-07-15T16:12:09Z
dc.date.issued2017
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85029030268&doi=10.1177%2f2192568217703085&partnerID=40&md5=2977f5c0004fdd7c30611db7c310c8d9
dc.identifier.urihttp://hdl.handle.net/10713/9909
dc.description.abstractIntroduction: The objective of this guideline is to outline the appropriate use of methylprednisolone sodium succinate (MPSS) in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MPSS in acute SCI. A multidisciplinary Guideline Development Group used this information, in combination with their clinical expertise, to develop recommendations for the use of MPSS. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: The main conclusions from the systematic review included the following: (1) there were no differences in motor score change at any time point in patients treated with MPSS compared to those not receiving steroids; (2) when MPSS was administered within 8 hours of injury, pooled results at 6- and 12-months indicated modest improvements in mean motor scores in the MPSS group compared with the control group; and (3) there was no statistical difference between treatment groups in the risk of complications. Our recommendations were: (1) “We suggest not offering a 24-hour infusion of high-dose MPSS to adult patients who present after 8 hours with acute SCI”; (2) “We suggest a 24-hour infusion of high-dose MPSS be offered to adult patients within 8 hours of acute SCI as a treatment option”; and (3) “We suggest not offering a 48-hour infusion of high-dose MPSS to adult patients with acute SCI.” Conclusions: These guidelines should be implemented into clinical practice to improve outcomes and reduce morbidity in SCI patients. Copyright The Author(s) 2017.en_US
dc.description.sponsorshipThis research was supported by AOSpine, the Ontario Neurotrauma Foundation (ONF) and the AANS/CNS Section on Neurotrauma and Critical Care.en_US
dc.description.urihttps://www.doi.org/10.1177/2192568217703085en_US
dc.language.isoen_USen_US
dc.publisherSAGE Publications Ltden_US
dc.relation.ispartofGlobal Spine Journal
dc.subjectacute spinal cord injuryen_US
dc.subjectguidelineen_US
dc.subjectmethylprednisolone sodium succinateen_US
dc.subjectMPSSen_US
dc.subjectspinal cord injuryen_US
dc.titleA Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Use of Methylprednisolone Sodium Succinateen_US
dc.typeArticleen_US
dc.identifier.doi10.1177/2192568217703085


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