Comparison the efficacy of the intrathecal with intravenous methylprednisolone administration in outcome of patients with acute thoracolumbar spinal cord injury(SCI)

Abstract

Acute complete spinal cord injury is accompanied by irreversible mechanical rupture of neurons and axons, which is an irreversible event. Despite numerous studies over the past 40 years, no effective and standard treatment for this disease has been identified. Of the drugs, methylprednisolone is the only drug that can be used in acute traumatic spinal cord injuries. Aim: In this study, we compared the efficacy of intravenously and intrathecally methylprednisolone in the outcome of acute thoracolumbar spinal cord injury. Method and materials: This study was a randomized controlled trial and was performed on 57 patients with acute spinal cord injury following thoracolumbar spine trauma referred to Imam Reza Hospital in Tabriz from 95 to 97. In this study patients were divided into two groups: intrathecal methylprednisolone (n = 29) and intravenous methylprednisolone (n = 28) groups. Results were analyzed by SPSS software (ver.21). they got. Results: Of 57 patients studied, 8 (14%) were female and 49 (85%) were male. In this study, the difference between the two groups based on Light Touch ASIA Score, Pin Prick ASIA Score, Motor ASIA Score, and modified frankel scale at baseline and discharge time and 6 months later follow up was not significant. complications during hospitalization were not significantly difference between groups .In this study, at the first day serum level of Malondialdehyde (MDA) in the intravenous methylprednisolone group was 2.12 ± 0.56 and in the intrathecal group was 2.36 ± 0.52, which was not significant between the two groups. Total antioxidant capacity (TAC) level in intravenous methylprednisolone group was 1.14 ± 0.4 and in intrathecal group was 1.26 ± 0.43, which was not significant (P value = 0.17) and on day 4 in intravenous group 1.02 ± 0.21 In the intrathecal group was 1.10± 0.32 (P value = 0.42)