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July 1989

Dangers From Methylprednisolone Acetate Therapy by Intraspinal Injection

Author Affiliations

Division of Neurosurgery Department of Surgery University of Massachusetts Medical Center 55 Lake Ave N Worcester, MA 06155

Arch Neurol. 1989;46(7):721. doi:10.1001/archneur.1989.00520430015007

To the Editor.  —I was disappointed to read Dr Dewey Nelson's latest contribution, "Dangers From Methylprednisolone Acetate Therapy by Intraspinal Injection," in the July 1988 issue of the Archives,1 to his long-standing crusade against intrathecal use of depository methylprednisolone acetate, not because he has correctly drawn attention to the potential risk of this therapy, but because his strong feelings on the subject have added immeasurably to the misery of those patients in whom the risk-benefit ratio of this therapy clearly justifies its use. In his zeal, Dr Nelson has ignored the considerable body of published literature and experience that attests to the benefit of intrathecal and epidural methylprednisolone acetate injections in patients whose lives have been made miserable from adhesive arachnoiditis, or other painful spinal conditions. My own experience with intrathecally administered methylprednisolone acetate therapy, which has been presented at several meetings and is being prepared for publication, has

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