Response to ‘The administration of high-dose methylprednisolone for 24 h reduced muscle size and increased atrophy-related gene expression in spinal cord-injured rats’

Wu et al.¹ are to be congratulated on their critical experimental work on the adverse effects of high-dose methylprednisolone in the treatment of spinal cord-injured rats. Methylprednisolone treatment was introduced some 20 years ago, and it has received widespread acceptance with a view to improve functional neurological outcome after an acute spinal injury. There is little evidence to support its use.

On the other hand, there has been a critical prospective randomised clinical trial by Pointillart et al.² between 1990 and 1995, which showed no benefit from the early use of methylprednisolone in spinal cord injuries.

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