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Current use of methylprednisolone for acute spinal cord injury in Poland: survey study
Grzegorz Miekisiak1, Wojciech Kloc, Witold Janusz
1Department of Neurosurgery, Specialist Medical Center, ul. Jana Pawla II 2, 57-320, Polanica-Zdroj, Poland, gmiekisiak@gmail.com.
Purpose:
The controversial practice of methylprednisolone (MP) application in acute spinal cord injury (ASCI) is gradually decreasing. This is a survey study designed to assess the current use of MP in ASCI in Poland.
Methods:
The questionnaire comprised of five questions was distributed among 251 spinal surgeons, members of the Polish Society of Spinal Surgery. One hundred and ten (43.8 %) responded, and data from 108 were included in the study.
Results:
Majority of respondents (73.1 %) declared the use of MP in ASCI. Most of them (41.7 %) adhered to the NASCIS II protocol, and 24.1 % rather used the NASCIS III protocol. Predominant rationale for the use of steroids was fear of litigation (36.7 %), 30.4 % declared it is as an institutional standard, nearly one-third believed in the effectiveness of drug in improving neurological outcomes. The subgroup analyses revealed no statistically significant interaction for specialty, age, personal involvement in care and institutional case volume.
Conclusions:
As opposed to the literature data from similar studies performed in other countries, the rate of use of MP in ASCI remains high.
Insights
Despite declining global trends, methylprednisolone (MP) use in acute spinal cord injury (ASCI) remains high in Poland. Fear of litigation and institutional standards are key reasons for its continued application.
Area of Science:
- Neurosurgery
- Traumatology
- Clinical Pharmacology
Background:
- The use of methylprednisolone (MP) in acute spinal cord injury (ASCI) is a controversial topic with decreasing application rates globally.
- Understanding current practices in different regions is crucial for evidence-based treatment guidelines.
Purpose of the Study:
- To assess the current utilization of methylprednisolone (MP) in the management of acute spinal cord injury (ASCI) within Poland.
- To identify the primary motivations behind the continued use of MP in ASCI.
Main Methods:
- A survey study was conducted among spinal surgeons in Poland.
- A five-question questionnaire was distributed to 251 members of the Polish Society of Spinal Surgery.
- Data from 108 respondents (43.8% response rate) were analyzed.
Main Results:
- A significant majority (73.1%) of Polish spinal surgeons reported using MP in ASCI.
- Adherence to the NASCIS II (41.7%) and NASCIS III (24.1%) protocols was reported.
- Primary reasons for MP use included fear of litigation (36.7%), institutional standards (30.4%), and perceived effectiveness in improving neurological outcomes (nearly one-third).
- No statistically significant interactions were found based on specialty, age, personal involvement in care, or institutional case volume.
Conclusions:
- The rate of methylprednisolone (MP) application in acute spinal cord injury (ASCI) in Poland remains high, contrasting with international trends.
- Continued use appears driven by medico-legal concerns and established institutional practices rather than solely by evidence of improved neurological outcomes.
