Miękisiak Grzegorz, Łątka Dariusz, Jarmużek Paweł, Załuski Rafał, Urbański Wiktor, Janusz Witold
Department of Neurosurgery, University Hospital, Opole, Poland.
Department of Neurosurgery, University Hospital, Opole, Poland.
World Neurosurg. 2019 Feb;122:e467-e471. doi: 10.1016/j.wneu.2018.09.239. Epub 2018 Oct 24.
Spinal cord injury (SCI) is a devastating event often leading to poor neurologic outcomes. One of the most widely practiced treatments has been the administration of methylprednisolone. However, today its use has been called into question over concerns of efficacy and safety. The present study evaluated the changes in the practice of steroid administration in acute SCI among members of the National Spinal Society in Poland in comparison with the results of the survey conducted in 2013.
The questionnaire, comprising 5 questions, was distributed among 240 spinal surgeons, members of the Polish Society of Spinal Surgery; of these, 97 (40%) responded. The results were compared with data from the previous survey conducted in 2013.
Over a period of 5 years, the prevalence of steroid administration in acute SCI has completely reversed; the proportion of steroid users declined from 73% to 27%. The main rationale for using it was belief in efficacy, rather than fear of litigation. The differences between specialization and age groups were not statistically significant in both administrations.
A significant decrease was observed in the number of surgeons using steroids in the acute SCI, similar to that reported in the literature. The critical appraisal of the existing clinical evidence, as well as the formulation of guidelines by professional organizations, exerted a profound impact on the practice pattern.
脊髓损伤（SCI）是一种灾难性事件，常常导致不良的神经学预后。最广泛应用的治疗方法之一是给予甲泼尼龙。然而，如今其使用因疗效和安全性问题而受到质疑。本研究评估了波兰国家脊柱协会成员在急性脊髓损伤中使用类固醇的情况变化，并与2013年进行的调查结果进行比较。
包含5个问题的问卷分发给了波兰脊柱外科学会的240名脊柱外科医生；其中97人（40%）做出了回应。结果与2013年进行的先前调查数据进行了比较。
在5年时间里，急性脊髓损伤中使用类固醇的比例完全逆转；使用类固醇的比例从73%降至27%。使用它的主要理由是相信其疗效，而非担心诉讼。在两次调查中，专业领域和年龄组之间的差异均无统计学意义。
与文献报道相似，观察到急性脊髓损伤中使用类固醇的外科医生数量显著减少。对现有临床证据的批判性评估以及专业组织制定的指南对实践模式产生了深远影响。
