Wang Luowen, Shi Genbing, Jin Yongjia, Mo Zongyi, Ren Zhaogan, Hua Zhanqiang
Department of Orthopedics, Shanghai Electric Power Hospital, No. 937 Yan'an West Road, Changning District, Shanghai, 200050, China.
Open Med (Wars). 2025 Mar 26;20(1):20241105. doi: 10.1515/med-2024-1105. eCollection 2025.
Methylprednisolone is preferably used in acute traumatic spinal cord injuries but its efficacy is limited. The objectives of the study were to evaluate the efficacy and safety of preoperative intraperitoneal erythropoietin plus a high dose of methylprednisolone against a high dose of methylprednisolone monotherapy in patients with traumatic spinal cord injuries.
In the retrospective study, patients received preoperative intraperitoneal erythropoietin + intravenous methylprednisolone (EM cohort, = 107) or methylprednisolone monotherapy (PE cohort, = 140).
The time between decompression surgeries and injuries was 34.58 ± 6.39 h/patient (maximum: 49 h). Neurologic and sphincter functions of patients at follow-up in the EM cohort exhibited better than the preoperative neurologic and sphincter functions in the same cohort and also neurologic and sphincter functions at follow-up in the PE cohort ( < 0.05 for all). Higher 30-day postoperative mortality was reported in the PE cohort (43 (31%) vs 20 (19%), = 0.0454) than those of the EM cohort.
Preoperative intraperitoneal erythropoietin plus a high dose of methylprednisolone appears to have a beneficial neuroprotective effect, exhibited improved sphincter functions, and decreased mortality more than a high dose of methylprednisolone monotherapy in patients with traumatic spinal cord injuries who underwent surgeries.
甲基强的松龙常用于急性创伤性脊髓损伤，但疗效有限。本研究的目的是评估术前腹腔注射促红细胞生成素联合大剂量甲基强的松龙与大剂量甲基强的松龙单药治疗相比，对创伤性脊髓损伤患者的疗效和安全性。
在这项回顾性研究中，患者接受术前腹腔注射促红细胞生成素+静脉注射甲基强的松龙（EM队列，n = 107）或甲基强的松龙单药治疗（PE队列，n = 140）。
减压手术与受伤之间的时间为34.58±6.39小时/患者（最长：49小时）。EM队列患者随访时的神经和括约肌功能优于同一队列术前的神经和括约肌功能，也优于PE队列随访时的神经和括约肌功能（所有比较P<0.05）。PE队列术后30天死亡率高于EM队列（43例（31%）对20例（19%），P = 0.0454）。
术前腹腔注射促红细胞生成素联合大剂量甲基强的松龙似乎具有有益的神经保护作用，在接受手术的创伤性脊髓损伤患者中，与大剂量甲基强的松龙单药治疗相比，可改善括约肌功能并降低死亡率。
