With steroids, epidural and otherwise, in the news lately
for their overuse when treating back pain (and their danger when tainted by fungal meningitis), it was high time for a policy change, and we've got one, from the Congress of Neurological Surgeons and the American Association of Neurological Surgeons. The organizations' Joint Section on Disorders of the Spine and Peripheral Nerves has released updated guidelines
for the management of acute spinal cord injury that recommend against
the use of steroids in the first 24-48 hours following an acute SCI. Steroids were "previously recommended with consideration to the risk / reward profile, as evaluated by the physician."