Current Use of Methylprednisolone for Acute Spinal Cord Injury by Spine Surgeons of Thailand

Abstract

Objective: To determine current decision making in methylprednisolone succinate (MPS) administration for acute spinal cord injury (ASCI) treatment in Thailand.
Methods:A questionnaire was sent to all orthopedic surgeons who attended the annual meeting of the Spine Society of Thailand 2016. The questionnaire had 3 parts of questions including demographic data, opinions in MPS use in general ASCI patients and patients who meet the exclusion criteria in NASCIS III study.
Results:Fifty-five respondents completed the survey (overall response rate was 27.1 %) and there was 78.18% prescribe MPS to ASCI patients. Among them, 40 % prescribe according to NASCIS II and 55.6% NASCIS III. The main reasons for MPS administration are practice standard (38.6%), effectiveness (31.8%) and liability issue (22.7%). In patients who met the exclusion criteria of NASCIS III, most respondents do not prescribe any steroids in patients who had age below 14 years old (42.2%), pregnancy (77.8%), severe underlying disease (72.7%), body weight more than 109 kg (40.9%), gunshot injury (59.1%) and previous spinal cord injury (46.5%). Interestingly, there were 93.2% prescribed MPS to patients who sustained ACSI more than 8 hours.
Conclusion:Because the institutional standard supported MPS use, most participants prescribed MPS in ASCI despite current clinical data from recent studies. Most participants who did not use MPS in patients had exclusion criteria of NASCIS III.