Evidence map›Paper›PMID 26065706›Full record

ArticleJournal of neurotrauma2015

Methylprednisolone for the Treatment of Patients with Acute Spinal Cord Injuries: A Propensity Score-Matched Cohort Study from a Canadian Multi-Center Spinal Cord Injury Registry.

Nathan Evaniew, Vanessa K Noonan, Nader Fallah, Brian K Kwon, Carly S Rivers, Henry Ahn, Christopher S Bailey, Sean D Christie, Daryl R Fourney, R John Hurlbert and 4 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurotrauma, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 6 pooled it
10.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 6 syntheses or guidelines pooled it, 159 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Duraplasty in acute spinal cord injury: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Pooled it
  4. "White Cord Syndrome" as clinical manifestation of the spinal cord reperfusion syndrome: a systematic review of risk factors, treatments, and outcome.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Pooled it
  5. Pooled it
  6. Cochrane in CORR1: Steroids for Acute Spinal Cord Injury (Review).Clinical orthopaedics and related research · 2016
    Pooled it
  7. Article
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  10. Review
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  15. Time is spine: critical updates for the intensivist.Current opinion in critical care · 2025
    Review
  16. Article
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  19. The role of antioxidants in facial nerve injury.Frontiers in molecular biosciences · 2025
    Review
  20. Article

15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 1 country.

Nathan Evaniew1 Division of Orthopaedics, McMaster University , Hamilton, Ontario, Canada .
Vanessa K Noonan2 Rick Hansen Institute, Vancouver, Canada .
Nader Fallah2 Rick Hansen Institute, Vancouver, Canada .
Brian K Kwon3 University of British Columbia , Vancouver, Canada .
Carly S Rivers2 Rick Hansen Institute, Vancouver, Canada .
Henry Ahn4 St. Michael's Hospital , Toronto, Ontario, Canada .
Christopher S Bailey6 Division of Orthopaedic Surgery, Western University ; London Health Services Centre, London, Ontario, Canada .
Sean D Christie7 Division of Neurosurgery-Halifax Infirmary, Dalhousie University , Halifax, Nova Scotia, Canada .
Daryl R Fourney8 Department of Surgery, University of Saskatchewan , Saskatoon, Saskatchewan, Canada .
R John Hurlbert9 University of Calgary Spine Program , Calgary, Alberta, Canada .
A G Linassi10 Department of Physical Medicine and Rehabilitation, University of Saskatchewan , Saskatoon, Saskatchewan, Canada.
Michael G Fehlings5 University of Toronto Spine Program, University of Toronto , Ontario, Canada .
Marcel F Dvorak3 University of British Columbia , Vancouver, Canada .
RHSCIR Network
Praxis Spinal Cord Institute · CAUniversity of British Columbia · CAUniversity of Saskatchewan · CADalhousie University · CAMcMaster University · CASt. Michael's Hospital · CAUniversity of Calgary · CAUniversity of Toronto · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In prior analyses of the effectiveness of methylprednisolone for the treatment of patients with acute traumatic spinal cord injuries (TSCIs), the prognostic importance of patients' neurological levels of injury and their baseline severity of impairment has not been considered. Our objective was to determine whether methylprednisolone improved motor recovery among participants in the Rick Hansen Spinal Cord Injury Registry (RHSCIR). We identified RHSCIR participants who received methylprednisolone according to the Second National Spinal Cord Injury Study (NASCIS-II) protocol and used propensity score matching to account for age, sex, time of neurological exam, varying neurological level of injury, and baseline severity of neurological impairment. We compared changes in total, upper extremity, and lower extremity motor scores using the Wilcoxon signed-rank test and performed sensitivity analyses using negative binomial regression. Forty-six patients received methylprednisolone and 1555 received no steroid treatment. There were no significant differences between matched participants for each of total (13.7 vs. 14.1, respectively; p=0.43), upper extremity (7.3 vs. 6.4; p=0.38), and lower extremity (6.5 vs. 7.7; p=0.40) motor recovery. This result was confirmed using a multivariate model and, as predicted, only cervical (C1-T1) rather than thoracolumbar (T2-L3) injury levels (p<0.01) and reduced baseline injury severity (American Spinal Injury Association [ASIA] Impairment Scale grades; p<0.01) were associated with greater motor score recovery. There was no in-hospital mortality in either group; however, the NASCIS-II methylprednisolone group had a significantly higher rate of total complications (61% vs. 36%; p=0.02) NASCIS-II methylprednisolone did not improve motor score recovery in RHSCIR patients with acute TSCIs in either the cervical or thoracic spine when the influence of anatomical level and severity of injury were included in the analysis. There was a significantly higher rate of total complications in the NASCIS-II methylprednisolone group. These findings support guideline recommendations against routine administration of methylprednisolone in acute TSCI.

Indexed as

Outcome Assessment, Health CareRegistriesAdultCanadaCohort StudiesFemaleGlucocorticoidsHumansMaleMethylprednisoloneMiddle AgedPropensity ScoreRecovery of FunctionSpinal Cord InjuriesGlucocorticoidsMethylprednisolonemethylprednisolonemotor scoreneurological recoverypropensity scored-matchedspinal cord injury

Identifiers

PMID26065706
PMCPMC4638202
OpenAlexW2162975212

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.