High-dose methylprednisolone for acute traumatic spinal cord injury: A meta-analysis

Objective Due to the continuing debates on the utility of high-dose methylprednisolone (MP) early after acute spinal cord injury (ASCI), we aim to evaluate the therapeutic and adverse effects of high-dose MP according to NASCIS-2 dosing protocol in comparison to no steroids on patients with ASCI, by performing a meta-analysis on the basis of the current available clinical trials. Methods We searched PubMed and Cochrane Library (to May 22 2018) for studies comparing neurological recoveries, adverse events and in-hospital costs between ASCI patients who underwent high-dose MP treatment or not. Data were synthesized with corresponding statistical models according to the degree of heterogeneity. Results We enrolled 16 studies (1863 participants) including 3 RCTs and 13 observational studies. Pooled results indicated that MP was not associated with an increase in motor score improvement (RCTs: p = 0.84; Observational studies: p = 0.44) and incidence of recovery by at least one grade on ...