• Jason C Eck, Dean Nachtigall, S Craig Humphreys, and Scott D Hodges.
• Department of Orthopaedic Surgery, Memorial Hospital, York, PA 17403, USA. jason-laurie@suscom.net
• Spine. 2006 Apr 20; 31 (9): E250-3.

Study DesignA questionnaire survey.ObjectiveEstimate the use and justification of the steroid protocol for spinal cord injury (SCI) patients.Summary Of Background DataThere remains significant debate over clinical benefits and potential complications of the steroid protocol for SCI patients.MethodsA survey was sent to spine surgeons requesting information on 1) specialization, 2) trauma center affiliation, 3) use of steroid protocol, 4) justification of using steroid protocol, and 5) SCI volume.ResultsResponses were received from 305 surgeons. Fourteen (4.6%) surgeons used steroids only if initiated before their consult, 262 (85.9%) would initiate if within the accepted 8-hour timeframe, 20 (6.6%) did not use steroids at all, and 9 (3.0%) used a different protocol. Justification for steroids use: 65 improved recovery, 64 institutional protocol, 110 medicolegal reasons, and 26 did not personally initiate steroids. Eighteen surgeons listed both clinical benefit and institutional protocol, and 22 others listed both institutional protocol and medicolegal reasons.ConclusionsThe majority (90.5%) of responding surgeons used the steroid protocol; however, only 24.1% used the steroid protocol due to a belief in improved clinical outcomes.

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