# High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries

## TL;DR

Adding erythropoietin to methylprednisolone treatment improves outcomes in spinal cord injury patients after surgery.

## Contribution

Combining preoperative erythropoietin with methylprednisolone reduces mortality and improves neurological and sphincter functions.

## Key findings

- Patients receiving erythropoietin plus methylprednisolone had better neurological and sphincter functions than those on methylprednisolone alone.
- Mortality was significantly lower in the erythropoietin plus methylprednisolone group.
- The treatment combination showed neuroprotective effects in traumatic spinal cord injury patients.

## Abstract

Methylprednisolone is preferably used in acute traumatic spinal cord injuries but its efficacy is limited. The objectives of the study were to evaluate the efficacy and safety of preoperative intraperitoneal erythropoietin plus a high dose of methylprednisolone against a high dose of methylprednisolone monotherapy in patients with traumatic spinal cord injuries.

In the retrospective study, patients received preoperative intraperitoneal erythropoietin + intravenous methylprednisolone (EM cohort, n = 107) or methylprednisolone monotherapy (PE cohort, n = 140).

The time between decompression surgeries and injuries was 34.58 ± 6.39 h/patient (maximum: 49 h). Neurologic and sphincter functions of patients at follow-up in the EM cohort exhibited better than the preoperative neurologic and sphincter functions in the same cohort and also neurologic and sphincter functions at follow-up in the PE cohort (p < 0.05 for all). Higher 30-day postoperative mortality was reported in the PE cohort (43 (31%) vs 20 (19%), p = 0.0454) than those of the EM cohort.

Preoperative intraperitoneal erythropoietin plus a high dose of methylprednisolone appears to have a beneficial neuroprotective effect, exhibited improved sphincter functions, and decreased mortality more than a high dose of methylprednisolone monotherapy in patients with traumatic spinal cord injuries who underwent surgeries.