Which therapy is controversial and not routinely recommended for spine injuries?

Which therapy is controversial and not routinely recommended for spine injuries?

• A. High-dose steroids
• B. Oxygen therapy
• C. IV fluids
• D. Vasopressors

Answer: (A)

High-dose steroids given after an acute spinal cord injury are controversial and not routinely recommended. The idea was to blunt secondary injury from inflammation, but large and well-designed studies have not shown a clear, meaningful neurologic benefit, while the risks are considerable. Patients can develop infections, hyperglycemia, gastrointestinal bleeding, wound complications, and other serious side effects. Because of this unfavorable balance, major guidelines no longer advocate routine use of high-dose steroids in most spine injury cases, reserving them only for rare, carefully selected situations after weighing potential benefits against harms. Oxygen therapy, IV fluids, and vasopressors are standard supportive measures. Ensuring adequate oxygen delivery to the spinal cord and maintaining stable blood pressure help minimize secondary injury by preserving perfusion. Oxygen supports tissue oxygenation; IV fluids maintain intravascular volume; vasopressors are used when there is hypotension or neurogenic shock to sustain perfusion pressures. The focus is on stabilization and preventing secondary damage, rather than on a therapy with uncertain and potentially harmful benefits.

High-dose steroids given after an acute spinal cord injury are controversial and not routinely recommended. The idea was to blunt secondary injury from inflammation, but large and well-designed studies have not shown a clear, meaningful neurologic benefit, while the risks are considerable. Patients can develop infections, hyperglycemia, gastrointestinal bleeding, wound complications, and other serious side effects. Because of this unfavorable balance, major guidelines no longer advocate routine use of high-dose steroids in most spine injury cases, reserving them only for rare, carefully selected situations after weighing potential benefits against harms.

Oxygen therapy, IV fluids, and vasopressors are standard supportive measures. Ensuring adequate oxygen delivery to the spinal cord and maintaining stable blood pressure help minimize secondary injury by preserving perfusion. Oxygen supports tissue oxygenation; IV fluids maintain intravascular volume; vasopressors are used when there is hypotension or neurogenic shock to sustain perfusion pressures. The focus is on stabilization and preventing secondary damage, rather than on a therapy with uncertain and potentially harmful benefits.