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

Arch Neurol. 1989;46(7):721-722.

	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.

—I wish to thank Dr Wilkinson for his stated position vis-a-vis methylprednisolone acetate and its intraspinal therapy. His points are these: (1) the risks of its use are miniscule compared with clinical efficacy, (2) few patients have had complications following its intrathecal use, and (3) the neurochemistry of polyethylene glycol was inaccurately reported by myself.¹

Goldstein et al² were the first to describe adhesive arachnoiditis from methylprednisolone acetate followed by 10 case reports by Nelson et al and Nelson,¹ as well as Bernat et al and Bernat,³ who reported arachnoiditis and pachymeningitis. Two patients underwent an operation, and the pathologic findings in the lumbar region of one revealed a thin gelatinous material that I did not believe was disk material, but was a component of methylprednisolone acetate.⁴ During this same time period, numerous complications and infections were reported.^5,6

At first, the 20 case reports . . . [Full Text PDF of this Article]

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