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Dewey Nelson (1988)
Dangers from methylprednisolone acetate therapy by intraspinal injection.Archives of neurology, 45 7
Arguelles J Wood KM (1980)
Degenerative lesions in rat sciatic nerves after local injection of methylprednisolone in sterile aqueous solutionRegional Anesth, 5
Abstract To the Editor. —The warnings of methylprednisolone use in epidural analgesia by Dr Nelson1 raises important issues for physicians caring for patients with chronic low-back pain. As he noted, there is no doubt that polyethylene glycol is neurotoxic, and is the likely cause for sterile meningitis when methylprednisolone is injected in the subarachnoid space. It is noteworthy that corticosteroids have not been approved for intrathecal use by the Food and Drug Administration. The package insert for methylprednisolone acetate (Depomedrol, Upjohn) states "not recommended" for subarachnoid injection.A large body of clinical experience suggests the use of local anesthetics and steroids in the epidural space is a safe and effective treatment for the conservative management of low back pain in which there is reasonable evidence that inflammation of nerve roots is the cause of the symptoms. Two steroids, methylprednisolone acetate, 40 to 80 mg (Depomedrol, Upjohn), and triamcinolone diacetate References 1. Nelson P. Dangers from methylprednisolone acetate therapy by intraspinal injection . Arch Neurol . 1988;45:804-806.Crossref 2. Wood KM, Arguelles J, Norenberg MD. Degenerative lesions in rat sciatic nerves after local injection of methylprednisolone in sterile aqueous solution . Regional Anesth . 1980;5:13-15.
Archives of Neurology – American Medical Association
Published: Nov 1, 1989
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