Treatment of Acute Spinal Cord Injury:
Methylprednisolone: Bolus dose of 30 mg/kg of body weight over 15 minutes, followed by a 45-minute pause, and then a 23-hour continuous infusion of 5.4 mg/kg/hr. (Bracken Regime or NASCIS II PROTOCOL).
In the NASCIS III protocol,
* The dose mentioned in NASCIS 2 for 24 h if patient presents <3 h after injury
* If patient presents between 3 and 8 h, give the above steroid infusion for total of 48 h
* Tirilizad mesylate (an antioxidant) has a similar effect to that of steroids if given in hyper acute phase
Newer agents: GM-1 ganglioside, naloxone (an opiate antagonist), and monosialganglioside.
* They are glycosphingolipids at outer cellular membranes at the central nervous system
* gangliosides may have a neuroprotection action, with more speedy recovery of motor and sensory function in partial cord injuries
Orthopaedic Surgeon, Ilizarov & Complex Trauma Specialist, Patna
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