Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data

Results of the second National Acute Spinal Cord Injury Study

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  • 1 Coordinating Center, National Spinal Cord Injury Study, Department of Epidemiology and Public Health, Yale University Medical School, New Haven, Connecticut
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✓ The 1-year follow-up data of a multicenter randomized controlled trial of methylprednisolone (30 mg/kg bolus and 5.4 mg/kg/hr for 23 hours) or naloxone (5.4 mg/kg bolus and 4.0 mg/kg/hr for 23 hours) treatment for acute spinal cord injury are reported and compared with placebo results. In patients treated with methylprednisolone within 8 hours of injury, increased recovery of neurological function was seen at 6 weeks and at 6 months and continued to be observed 1 year after injury. For motor function, this difference was statistically significant (p = 0.030), and was found in patients with total sensory and motor loss in the emergency room (p = 0.019) and in those with some preservation of motor and sensory function (p = 0.024). Naloxone-treated patients did not show significantly greater recovery. Patients treated after 8 hours of injury recovered less motor function if receiving methylprednisolone (p = 0.08) or naloxone (p = 0.10) as compared with those given placebo. Complication and mortality rates were similar in either group of treated patients as compared with the placebo group. The authors conclude that treatment with the study dose of methylprednisolone is indicated for acute spinal cord trauma, but only if it can be started within 8 hours of injury.

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  • 1.

    Anderson DK, , Means ED, & Waters TR, et al: Microvascular perfusion and metabolism in injured spinal cord after methylprednisolone treatment. J Neurosurg 56:106113, 1982 Anderson DK, Means ED, Waters TR, et al: Microvascular perfusion and metabolism in injured spinal cord after methylprednisolone treatment. J Neurosurg 56:106–113, 1982

    • Search Google Scholar
    • Export Citation
  • 2.

    Anderson DK, , Saunders RD, & Demediuk P, et al: Lipid hydrolysis and peroxidation in injured spinal cord: partial protection with methylprednisolone or vitamin E and selenium. Cent Nerv Syst Trauma 2:257267, 1985 Anderson DK, Saunders RD, Demediuk P, et al: Lipid hydrolysis and peroxidation in injured spinal cord: partial protection with methylprednisolone or vitamin E and selenium. Cent Nerv Syst Trauma 2:257–267, 1985

    • Search Google Scholar
    • Export Citation
  • 3.

    Bishop YMM, , Fienberg SE, & Holland PW: Discrete Multivariate Analysis: Theory and Practice. Cambridge, Mass: MIT Press, 1975 Bishop YMM, Fienberg SE, Holland PW: Discrete Multivariate Analysis: Theory and Practice. Cambridge, Mass: MIT Press, 1975

    • Search Google Scholar
    • Export Citation
  • 4.

    Black P, & Markowitz RS: Experimental spinal cord injury in monkeys: comparison of steroids and local hypothermia. Surg Forum 22:409411, 1971 Black P, Markowitz RS: Experimental spinal cord injury in monkeys: comparison of steroids and local hypothermia. Surg Forum 22:409–411, 1971

    • Search Google Scholar
    • Export Citation
  • 5.

    Black P, , Markowitz RS, & Keller S, et al: Naloxone and experimental spinal cord injury: Part 1. High dose administration in a static load compression model. Neurosurgery 19:905908, 1986 Black P, Markowitz RS, Keller S, et al: Naloxone and experimental spinal cord injury: Part 1. High dose administration in a static load compression model. Neurosurgery 19:905–908, 1986

    • Search Google Scholar
    • Export Citation
  • 6.

    Black P, , Markowitz RS, & Keller S, et al: Naloxone and experimental spinal cord injury: Part 2. Megadose treatment in a dynamic load injury model. Neurosurgery 19:909913, 1986 Black P, Markowitz RS, Keller S, et al: Naloxone and experimental spinal cord injury: Part 2. Megadose treatment in a dynamic load injury model. Neurosurgery 19:909–913, 1986

    • Search Google Scholar
    • Export Citation
  • 7.

    Bracken MB, , Collins WF, & Freeman DF, et al: Efficacy of methylprednisolone in acute spinal cord injury. JAMA 251:4552, 1984 Bracken MB, Collins WF, Freeman DF, et al: Efficacy of methylprednisolone in acute spinal cord injury. JAMA 251:45–52, 1984

    • Search Google Scholar
    • Export Citation
  • 8.

    Bracken MB, , Shepard MJ, & Collins WF, et al: A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal cord injury. Results of the second National Acute Spinal Cord Injury Study. N Engl J Med 322:14051411, 1990 Bracken MB, Shepard MJ, Collins WF, et al: A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal cord injury. Results of the second National Acute Spinal Cord Injury Study. N Engl J Med 322:1405–1411, 1990

    • Search Google Scholar
    • Export Citation
  • 9.

    Bracken MB, , Shepard MJ, & Hellenbrand KG, et al: Methylprednisolone and neurological function 1 year after spinal cord injury. Results of the National Acute Spinal Cord Injury Study. J Neurosurg 63:704713, 1985 Bracken MB, Shepard MJ, Hellenbrand KG, et al: Methylprednisolone and neurological function 1 year after spinal cord injury. Results of the National Acute Spinal Cord Injury Study. J Neurosurg 63:704–713, 1985

    • Search Google Scholar
    • Export Citation
  • 10.

    Braughler JM, & Hall ED: Acute enhancement of spinal cord synaptosomal (Na+ + K+)-ATPase activity in cats following intravenous methylprednisolone. Brain Res 219:464469, 1981 Braughler JM, Hall ED: Acute enhancement of spinal cord synaptosomal (Na+ + K+)-ATPase activity in cats following intravenous methylprednisolone. Brain Res 219:464–469, 1981

    • Search Google Scholar
    • Export Citation
  • 11.

    Braughler JM, & Hall ED: Correlation of methylprednisolone levels in cat spinal cord with its effects on (Na+ + K+)-ATPase, lipid peroxidation, and alpha motor neuron function. J Neurosurg 56:838844, 1982 Braughler JM, Hall ED: Correlation of methylprednisolone levels in cat spinal cord with its effects on (Na+ + K+)-ATPase, lipid peroxidation, and alpha motor neuron function. J Neurosurg 56:838–844, 1982

    • Search Google Scholar
    • Export Citation
  • 12.

    Braughler JM, & Hall ED: Effects of multi-dose methylprednisolone sodium succinate administration on injured cat spinal cord neurofilament degradation and energy metabolism. J Neurosurg 61:290295, 1984 Braughler JM, Hall ED: Effects of multi-dose methylprednisolone sodium succinate administration on injured cat spinal cord neurofilament degradation and energy metabolism. J Neurosurg 61:290–295, 1984

    • Search Google Scholar
    • Export Citation
  • 13.

    Braughler JM, & Hall ED: Lactate and pyruvate metabolism in injured cat spinal cord before and after a single large intravenous dose of methylprednisolone. J Neurosurg 59:256261, 1983 Braughler JM, Hall ED: Lactate and pyruvate metabolism in injured cat spinal cord before and after a single large intravenous dose of methylprednisolone. J Neurosurg 59:256–261, 1983

    • Search Google Scholar
    • Export Citation
  • 14.

    Braughler JM, , Hall ED, & Means ED, et al: Evaluation of an intensive methylprednisolone sodium succinate dosing regimen in experimental spinal cord injury. J Neurosurg 67:102105, 1987 Braughler JM, Hall ED, Means ED, et al: Evaluation of an intensive methylprednisolone sodium succinate dosing regimen in experimental spinal cord injury. J Neurosurg 67:102–105, 1987

    • Search Google Scholar
    • Export Citation
  • 15.

    Campbell JB, , DeCrescito V, & Tomasula JJ, et al: Effects of antifibrinolytic and steroid therapy on the contused spinal cord of cats. J Neurosurg 40:726733, 1974 Campbell JB, DeCrescito V, Tomasula JJ, et al: Effects of antifibrinolytic and steroid therapy on the contused spinal cord of cats. J Neurosurg 40:726–733, 1974

    • Search Google Scholar
    • Export Citation
  • 16.

    Campbell JB, , DeCrescito V, & Tomasula JJ, et al: Experimental treatment of spinal cord contusion in the cat. Surg Neurol 1:102106, 1973 Campbell JB, DeCrescito V, Tomasula JJ, et al: Experimental treatment of spinal cord contusion in the cat. Surg Neurol 1:102–106, 1973

    • Search Google Scholar
    • Export Citation
  • 17.

    de la Torre JC, , Johnson CM, & Goode DJ, et al: Pharmacologic treatment and evaluation of permanent experimental spinal cord trauma. Neurology 25:508514, 1975 de la Torre JC, Johnson CM, Goode DJ, et al: Pharmacologic treatment and evaluation of permanent experimental spinal cord trauma. Neurology 25:508–514, 1975

    • Search Google Scholar
    • Export Citation
  • 18.

    Demopoulos HB, , Flamm ES, & Pietronigro DD, et al: The free radical pathology and the microcirculation in the major central nervous system disorders. Acta Physiol Scand (Suppl 111) 492:91119, 1980 Demopoulos HB, Flamm ES, Pietronigro DD, et al: The free radical pathology and the microcirculation in the major central nervous system disorders. Acta Physiol Scand (Suppl 111) 492:91–119, 1980

    • Search Google Scholar
    • Export Citation
  • 19.

    Demopoulos HB, , Milvy P, & Kakari S, et al: Molecular aspects of membrane structure in cerebral edema, in Reulen HJ, & Schürmann K (eds): Steroids and Brain Edema. Berlin: Springer-Verlag, 1972, pp 2939 Demopoulos HB, Milvy P, Kakari S, et al: Molecular aspects of membrane structure in cerebral edema, in Reulen HJ, Schürmann K (eds): Steroids and Brain Edema. Berlin: Springer-Verlag, 1972, pp 29–39

    • Search Google Scholar
    • Export Citation
  • 20.

    Ducker TB, & Hamit HF: Experimental treatments of acute spinal cord injury. J Neurosurg 30:693697, 1969 Ducker TB, Hamit HF: Experimental treatments of acute spinal cord injury. J Neurosurg 30:693–697, 1969

    • Search Google Scholar
    • Export Citation
  • 21.

    Eidelberg E, , Staten E, & Watkins CJ, et al: Treatment of experimental spinal cord injury in ferrets. Surg Neurol 6:243246, 1976 Eidelberg E, Staten E, Watkins CJ, et al: Treatment of experimental spinal cord injury in ferrets. Surg Neurol 6:243–246, 1976

    • Search Google Scholar
    • Export Citation
  • 22.

    Faden AI, , Jacobs TP, & Holaday JW: Opiate antagonist improves neurologic recovery after spinal injury. Science 211:493494, 1981 Faden AI, Jacobs TP, Holaday JW: Opiate antagonist improves neurologic recovery after spinal injury. Science 211:493–494, 1981

    • Search Google Scholar
    • Export Citation
  • 23.

    Faden AI, , Jacobs TP, & Mougey E, et al: Endorphins in experimental spinal injury: therapeutic effect of naloxone. Ann Neurol 10:326332, 1981 Faden AI, Jacobs TP, Mougey E, et al: Endorphins in experimental spinal injury: therapeutic effect of naloxone. Ann Neurol 10:326–332, 1981

    • Search Google Scholar
    • Export Citation
  • 24.

    Feringa ER, , Johnson RD, & Wendt JS: Spinal cord regeneration in rats after immunosuppresive treatment. Theoretic considerations and historical results. Arch Neurol 32:676683, 1975 Feringa ER, Johnson RD, Wendt JS: Spinal cord regeneration in rats after immunosuppresive treatment. Theoretic considerations and historical results. Arch Neurol 32:676–683, 1975

    • Search Google Scholar
    • Export Citation
  • 25.

    Flamm ES, , Young W, & Collins WF, et al: A Phase I trial of naloxone treatment in acute spinal cord injury. J Neurosurg 63:390397, 1985 Flamm ES, Young W, Collins WF, et al: A Phase I trial of naloxone treatment in acute spinal cord injury. J Neurosurg 63:390–397, 1985

    • Search Google Scholar
    • Export Citation
  • 26.

    Flamm ES, , Young W, & Demopoulos HB, et al: Experimental spinal cord injury: treatment with naloxone. Neurosurgery 10:227231, 1982 Flamm ES, Young W, Demopoulos HB, et al: Experimental spinal cord injury: treatment with naloxone. Neurosurgery 10:227–231, 1982

    • Search Google Scholar
    • Export Citation
  • 27.

    Fuenfer MM, , Olson GE, & Polk HC Jr: Effect of various corticosteroids upon the phagocytic bactericidal activity of neutrophils. Surgery 78:2733, 1975 Fuenfer MM, Olson GE, Polk HC Jr: Effect of various corticosteroids upon the phagocytic bactericidal activity of neutrophils. Surgery 78:27–33, 1975

    • Search Google Scholar
    • Export Citation
  • 28.

    Green BA, , Kahn T, & Klose KJ: A comparative study of steroid therapy in acute experimental spinal cord injury. Surg Neurol 13:9197, 1980 Green BA, Kahn T, Klose KJ: A comparative study of steroid therapy in acute experimental spinal cord injury. Surg Neurol 13:91–97, 1980

    • Search Google Scholar
    • Export Citation
  • 29.

    Haghighi SS, & Chehrazi B: Effect of naloxone in experimental acute spinal cord injury. Neurosurgery 20:385388, 1987 Haghighi SS, Chehrazi B: Effect of naloxone in experimental acute spinal cord injury. Neurosurgery 20:385–388, 1987

    • Search Google Scholar
    • Export Citation
  • 30.

    Hall ED: Acute effects of intravenous glucocorticoid on cat spinal motor neuron electrical properties. Brain Res 240:186190, 1982 Hall ED: Acute effects of intravenous glucocorticoid on cat spinal motor neuron electrical properties. Brain Res 240:186–190, 1982

    • Search Google Scholar
    • Export Citation
  • 31.

    Hall ED: Glucocorticoid effects on central nervous excitability and synaptic transmission. Int Rev Neurobiol 23:165195, 1982 Hall ED: Glucocorticoid effects on central nervous excitability and synaptic transmission. Int Rev Neurobiol 23:165–195, 1982

    • Search Google Scholar
    • Export Citation
  • 32.

    Hall ED, & Baker T: Acute effects of methylprednisolone sodium succinate on spinal reflexes. Exp Neurol 63:476484, 1979 Hall ED, Baker T: Acute effects of methylprednisolone sodium succinate on spinal reflexes. Exp Neurol 63:476–484, 1979

    • Search Google Scholar
    • Export Citation
  • 33.

    Hall ED, & Braughler JM: Acute effects of intravenous glucocorticoid pretreatment on the in vitro peroxidation of cat spinal cord tissue. Exp Neurol 73:321324, 1981 Hall ED, Braughler JM: Acute effects of intravenous glucocorticoid pretreatment on the in vitro peroxidation of cat spinal cord tissue. Exp Neurol 73:321–324, 1981

    • Search Google Scholar
    • Export Citation
  • 34.

    Hall ED, & Braughler JM: Effects of intravenous methylprednisolone on spinal cord lipid peroxidation and (Na+ + K+)-ATPase activity. Dose-response analysis during 1st hour after contusion injury in the cat. J Neurosurg 57:247253, 1982 Hall ED, Braughler JM: Effects of intravenous methylprednisolone on spinal cord lipid peroxidation and (Na+ + K+)-ATPase activity. Dose-response analysis during 1st hour after contusion injury in the cat. J Neurosurg 57:247–253, 1982

    • Search Google Scholar
    • Export Citation
  • 35.

    Hall ED, & Braughler JM: Glucocorticoid mechanisms in acute spinal cord injury: a review and therapeutic rationale. Surg Neurol 18:320327, 1982 Hall ED, Braughler JM: Glucocorticoid mechanisms in acute spinal cord injury: a review and therapeutic rationale. Surg Neurol 18:320–327, 1982

    • Search Google Scholar
    • Export Citation
  • 36.

    Hall ED, & Wolf DL: Methylprednisolone preservation of motor nerve function during early degeneration. Exp Neurol 84:715720, 1984 Hall ED, Wolf DL: Methylprednisolone preservation of motor nerve function during early degeneration. Exp Neurol 84:715–720, 1984

    • Search Google Scholar
    • Export Citation
  • 37.

    Hall ED, , Wolf DL, & Braughler JM: Effects of a single large dose of methylprednisolone sodium succinate on experimental posttraumatic spinal cord ischemia. Dose-response and time-action analysis. J Neurosurg 61:124130, 1984 Hall ED, Wolf DL, Braughler JM: Effects of a single large dose of methylprednisolone sodium succinate on experimental posttraumatic spinal cord ischemia. Dose-response and time-action analysis. J Neurosurg 61:124–130, 1984

    • Search Google Scholar
    • Export Citation
  • 38.

    Hansebout RR, , Kuchner EF, & Romero-Sierre C: Effects of local hypothermia and of steroids upon recovery from experimental spinal cord compression injury. Surg Neurol 4:531536, 1975 Hansebout RR, Kuchner EF, Romero-Sierre C: Effects of local hypothermia and of steroids upon recovery from experimental spinal cord compression injury. Surg Neurol 4:531–536, 1975

    • Search Google Scholar
    • Export Citation
  • 39.

    Hedeman LS, & Sil R: Studies in experimental spinal cord trauma. Part 2: Comparison of treatment with steroids, low molecular weight dextran, and catecholamine blockade. J Neurosurg 40:4451, 1974 Hedeman LS, Sil R: Studies in experimental spinal cord trauma. Part 2: Comparison of treatment with steroids, low molecular weight dextran, and catecholamine blockade. J Neurosurg 40:44–51, 1974

    • Search Google Scholar
    • Export Citation
  • 40.

    Kajihara K, , Kawanaga H, & de la Torre JC, et al: Dimethyl sulfoxide in the treatment of experimental acute spinal cord injury. Surg Neurol 1:1622, 1973 Kajihara K, Kawanaga H, de la Torre JC, et al: Dimethyl sulfoxide in the treatment of experimental acute spinal cord injury. Surg Neurol 1:16–22, 1973

    • Search Google Scholar
    • Export Citation
  • 41.

    Kalbfleisch JD, & Prentice LC: The Statistical Analysis of Failure Time Data. New York: John Wiley & Sons, 1980 Kalbfleisch JD, Prentice LC: The Statistical Analysis of Failure Time Data. New York: John Wiley & Sons, 1980

    • Search Google Scholar
    • Export Citation
  • 42.

    Kaplan EL, & Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457481, 1958 Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481, 1958

    • Search Google Scholar
    • Export Citation
  • 43.

    Kelly TA: The role of the immune system in central nervous system regeneration (theoretical considerations). Med Hypotheses 26:1315, 1988 Kelly TA: The role of the immune system in central nervous system regeneration (theoretical considerations). Med Hypotheses 26:13–15, 1988

    • Search Google Scholar
    • Export Citation
  • 44.

    Kuchner EF, & Hansebout RR: Combined steroid and hypothermia treatment of experimental spinal cord injury. Surg Neurol 6:371376, 1976 Kuchner EF, Hansebout RR: Combined steroid and hypothermia treatment of experimental spinal cord injury. Surg Neurol 6:371–376, 1976

    • Search Google Scholar
    • Export Citation
  • 45.

    Lewin MG, , Hansebout RR, & Pappius HM: Chemical characteristics of traumatic spinal cord edema in cats. Effect of steroids on potassium depletion. J Neurosurg 40:6575, 1974 Lewin MG, Hansebout RR, Pappius HM: Chemical characteristics of traumatic spinal cord edema in cats. Effect of steroids on potassium depletion. J Neurosurg 40:65–75, 1974

    • Search Google Scholar
    • Export Citation
  • 46.

    Means ED, , Anderson DK, & Waters TR, et al: Effect of methylprednisolone in compression trauma to the feline spinal cord. J Neurosurg 55:200208, 1981 Means ED, Anderson DK, Waters TR, et al: Effect of methylprednisolone in compression trauma to the feline spinal cord. J Neurosurg 55:200–208, 1981

    • Search Google Scholar
    • Export Citation
  • 47.

    Naftchi NE, , Demeny M, & DeCrescito V, et al: Biogenic amine concentrations in traumatized spinal cords of cats. Effect of drug therapy. J Neurosurg 40:5257, 1974 Naftchi NE, Demeny M, DeCrescito V, et al: Biogenic amine concentrations in traumatized spinal cords of cats. Effect of drug therapy. J Neurosurg 40:52–57, 1974

    • Search Google Scholar
    • Export Citation
  • 48.

    O'Flaherty JT, , Craddock PR, & Jacob HS: Mechanism of anti-complementary activity of corticosteroids in vivo: possible relevance in endotoxin shock (39638). Proc Soc Exp Biol Med 154:206209, 1977 O'Flaherty JT, Craddock PR, Jacob HS: Mechanism of anti-complementary activity of corticosteroids in vivo: possible relevance in endotoxin shock (39638). Proc Soc Exp Biol Med 154:206–209, 1977

    • Search Google Scholar
    • Export Citation
  • 49.

    Richardson HD, & Nakamaura S: An electron microscopic study of spinal cord edema and the effect of treatment with steroids, mannitol, and hypothermia. Proc Veterans Adm Spinal Cord Inj Conf 18:1016, 1971 Richardson HD, Nakamaura S: An electron microscopic study of spinal cord edema and the effect of treatment with steroids, mannitol, and hypothermia. Proc Veterans Adm Spinal Cord Inj Conf 18:10–16, 1971

    • Search Google Scholar
    • Export Citation
  • 50.

    Saunders RD, , Dugan LL, & Demediuk P, et al: Effects of methylprednisolone and the combination of alpha-to-copherol and selenium on arachidonic acid metabolism and lipid peroxidation in traumatized spinal cord tissue. J Neurochem 49:2431, 1987 Saunders RD, Dugan LL, Demediuk P, et al: Effects of methylprednisolone and the combination of alpha-to-copherol and selenium on arachidonic acid metabolism and lipid peroxidation in traumatized spinal cord tissue. J Neurochem 49:24–31, 1987

    • Search Google Scholar
    • Export Citation
  • 51.

    Scheff SW, , Hoff SF, & Anderson KJ: Altered regulation of lesion-induced synaptogenesis by adrenalectomy and corticosterone in young adult rats. Exp Neurol 93:456470, 1986 Scheff SW, Hoff SF, Anderson KJ: Altered regulation of lesion-induced synaptogenesis by adrenalectomy and corticosterone in young adult rats. Exp Neurol 93:456–470, 1986

    • Search Google Scholar
    • Export Citation
  • 52.

    Wallace MC, & Tator CH: Failure of blood transfusion or naloxone to improve clinical recovery after experimental spinal cord injury. Neurosurgery 19:489494, 1986 Wallace MC, Tator CH: Failure of blood transfusion or naloxone to improve clinical recovery after experimental spinal cord injury. Neurosurgery 19:489–494, 1986

    • Search Google Scholar
    • Export Citation
  • 53.

    Wilson JW: Cellular localization of 3H-labeled corticosteroids by electron microscopic autoradiography after hemorrhagic shock, in Glenn TM (ed): Steroids and Shock. Baltimore: University Park Press, 1974, pp 275299 Wilson JW: Cellular localization of 3H-labeled corticosteroids by electron microscopic autoradiography after hemorrhagic shock, in Glenn TM (ed): Steroids and Shock. Baltimore: University Park Press, 1974, pp 275–299

    • Search Google Scholar
    • Export Citation
  • 54.

    Yeo JD, , Payne W, & Hinwood B: The experimental contusion injury of the spinal cord in sheep. Paraplegia 12:275296, 1975 Yeo JD, Payne W, Hinwood B: The experimental contusion injury of the spinal cord in sheep. Paraplegia 12:275–296, 1975

    • Search Google Scholar
    • Export Citation
  • 55.

    Young W: Blood flow, metabolic and neurophysiological mechanisms in spinal cord injury, in Becker DP, & Povlishock JT (eds): Central Nervous System Trauma Status Report. Washington, DC: NINCDS, 1985, pp 463473 Young W: Blood flow, metabolic and neurophysiological mechanisms in spinal cord injury, in Becker DP, Povlishock JT (eds): Central Nervous System Trauma Status Report. Washington, DC: NINCDS, 1985, pp 463–473

    • Search Google Scholar
    • Export Citation
  • 56.

    Young W, & Flamm ES: Effect of high-dose corticosteroid therapy on blood flow, evoked potentials, and extracellular calcium in experimental spinal injury. J Neurosurg 57:667673, 1982 Young W, Flamm ES: Effect of high-dose corticosteroid therapy on blood flow, evoked potentials, and extracellular calcium in experimental spinal injury. J Neurosurg 57:667–673, 1982

    • Search Google Scholar
    • Export Citation
  • 57.

    Young W, , Flamm ES, & Demopoulos HB, et al: Effect of naloxone on posttraumatic ischemia in experimental spinal contusion. J Neurosurg 55:209219, 1981 Young W, Flamm ES, Demopoulos HB, et al: Effect of naloxone on posttraumatic ischemia in experimental spinal contusion. J Neurosurg 55:209–219, 1981

    • Search Google Scholar
    • Export Citation

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