The Use of Steroids in Spinal Cord Injuries: Origins of a Controversy

Eric Dennis C. Legaspi

Division of Neurological Surgery, Department of Neurosciences, College of Medicine and
Philippine General Hospital, University of the Philippines Manila

The use of steroids in the treatment of acute spinal cord injuries is a wide-spread practice that is often considered a local standard of care. It has even occasionally made its way to being a legal standard of practice. For  instance, in 1998, a team of physicians was found liable for inadequately addressing the spinal cord injury of an infant under their care.

During a high forceps delivery, the head of the infant had been inadvertently rotated 180 degrees rendering the child quadriplegic and ventilator dependent. Sixty percent of the penalty imposed on the medical team was assigned to the neonatologists who attended the child  after  the injury had occurred, in part because: "Two expert witnesses testified that had steroids been administered within an 8 hour window post-injury, there would have been a 95% probability of significant improvement in the infant's ability to breathe and move her arms."

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