The analgesic effect of intravenous methylprednisolone on acute neuropathic pain with allodynia due to central cord syndrome: a retrospective study

Liandong Li,1 Yawei Han,2 Tengshuai Li,1 Jiaming Zhou,1 Chao Sun,3,4 Yuan Xue1 1Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Tianjin, China; 2Department of Histology and Embryology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China; 3Department of Orthopaedics Surgery, Tianjin Metabolic Diseases Hospital & Tianjin Institution of Endocrinology, Tianjin, China; 4Key Lab of Hormones and Development (National Health and Family Planning Commission of the PRC), Tianjin Key Laboratory of Metabolic Diseases, Tianjin, China Background: Central cord syndrome (CCS) may be associated with severe neuropathic pain that often resists to conventional pain therapy regimens and affects the patients’ quality of life (QoL) seriously. Current treatments for CCS-associated neuropathic pain have limited evidence of efficacy. This retrospective study was performed to present the effects of early treatment with methylprednisolone (MP) on acute neuropathic pain relief and the QoL in CCS patients.Patients and methods: Data were collected from the medical records of CCS patients who suffered from acute neuropathic pain with allodynia. All the patients received intravenous MP treatment for up to 1 week. Patients were evaluated with standard measures of efficacy: neuropathic pain intensity, the area of allodynia, and the QoL at baseline, daily treatment, and at 1 and 3 months after the end of MP treatment.Results: Thirty-four eligible patients were enrolled in our study. By the end of MP treatment, the proportion of patients who gained total or major (visual analog scale [VAS] score decreased by 50% or more) allodynia relief from the treatment was 91.18%, and a decrease in spontaneous pain was also observed. Moreover, this study showed MP could significantly improve the QoL of patients based on McGill Pain Questionnaire Short Form and EuroQol Five Dimensions Questionnaire. Four patients (11.76%) during MP treatment experienced mild or moderate side effects. None of the patients manifested CCS-associated neuropathic pain recurrence and MP-associated side effects at follow-up. Conclusion: The current results suggested that MP offered an effective therapeutic alternative for relieving CCS-associated acute neuropathic pain with allodynia. Given the encouraging results of this study, it would be worthwhile to confirm these results in randomized placebo-controlled clinical trials. Keywords: spinal cord injury, spontaneous pain, visual analog scal