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Dewey A. Nelson, MD
Omega Professional Center 48 Omega Dr Newark, DE 19713

Arch Neurol. 1989;46(7):720-721.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—Dr Abram agreed that intrathecal therapy with methylprednisolone acetate carries risks; however, he believed that epidural injections are safe and that inadvertent subarachnoid injections are rare. The posterior interspinous ligaments are entered by inadvertency in a variable number of procedures, but not the 42.5% I quoted due to typographical error. The introducing of medications into ligaments is quoted by some authors at 25%,¹ which is obviously not as serious as accidental spinal taps, which occur from 0.5% to 2.5%.¹ These facts are more impressive when it is realized that methylprednisolone acetate administered by the intrathecal route gives rise to (radiographically proven) arachnoiditis in virtually 100% of patients.²

Winnie et al³ originally recommended the use of methylprednisolone acetate epidurally, followed in 1978 by a report of meningitis and severe neurologic damage⁴. After Delaney et al⁵ studied the use of a similar steroid compound in cats . . . [Full Text PDF of this Article]

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