• Grzegorz Miękisiak, Dariusz Łątka, Paweł Jarmużek, Rafał Załuski, Wiktor Urbański, and Witold Janusz.
• Department of Neurosurgery, University Hospital, Opole, Poland. Electronic address: gmiekisiak@gmail.com.
• World Neurosurg. 2019 Feb 1; 122: e467-e471.

BackgroundSpinal cord injury (SCI) is a devastating event often leading to poor neurologic outcomes. One of the most widely practiced treatments has been the administration of methylprednisolone. However, today its use has been called into question over concerns of efficacy and safety. The present study evaluated the changes in the practice of steroid administration in acute SCI among members of the National Spinal Society in Poland in comparison with the results of the survey conducted in 2013.MethodsThe questionnaire, comprising 5 questions, was distributed among 240 spinal surgeons, members of the Polish Society of Spinal Surgery; of these, 97 (40%) responded. The results were compared with data from the previous survey conducted in 2013.ResultsOver a period of 5 years, the prevalence of steroid administration in acute SCI has completely reversed; the proportion of steroid users declined from 73% to 27%. The main rationale for using it was belief in efficacy, rather than fear of litigation. The differences between specialization and age groups were not statistically significant in both administrations.ConclusionsA significant decrease was observed in the number of surgeons using steroids in the acute SCI, similar to that reported in the literature. The critical appraisal of the existing clinical evidence, as well as the formulation of guidelines by professional organizations, exerted a profound impact on the practice pattern.Copyright © 2018 Elsevier Inc. All rights reserved.

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