title: The clinical efficacy of short-term steroid treatment in multilevel anterior cervical arthrodesis.
abstract: BACKGROUND
  Dysphagia is the most common complication of anterior cervical discectomy and fusion (ACDF), and it is closely related to prevertebral soft-tissue swelling (PSTS). A few studies have found that local or systemic methylprednisolone is effective against laryngopharyngeal edema and airway obstruction.
  
  
  OBJECTIVE
  To assess the effectiveness of short-term use of systemic methylprednisolone in relieving dysphagia and decreasing PSTS during the hospitalization period.
  
  
  METHODS
  A prospective study.
  
  
  METHODS
  Forty patients who underwent multilevel (more than three levels) ACDF with same plate fixation.
  
  
  METHODS
  Radiologic and clinical measures.
  
  
  METHODS
  Twenty of these patients were given 250 mg of methylprednisolone intravenously (IV) four times a day only for 24 hours after the operation (at 6-hour intervals), whereas the remaining 20 did not receive methylprednisolone and served as controls. We used the Bazaz scale to compare the degree of dysphagia between groups during the hospitalization period. We used the C-spine lateral view to assess the degree of pre- and postoperative PSTS from C2 to C7. At the final follow-up, we assessed the relationship between the occurrence of complications and steroid use.
  
  
  RESULTS
  The degree of dysphagia according to the Bazaz scale was less severe in the group that received methylprednisolone (p values; postoperative Day [POD] 2∼5<.05, POD 6=.014, POD 7=.019). Prevertebral soft-tissue swelling was also significantly lower in the group that received methylprednisolone (p values; POD 2∼POD 5 <.005, POD 1=.061, POD 6=.007, POD 7=.091). The amount of PSTS and dysphagia did not differ according to sex, age, smoking history, or length of surgery. The period of hospitalization in the experimental group was shorter than in the control group. No complications related to steroid use were found at the final follow-up.
  
  
  CONCLUSIONS
  The short-term use of systemic methylprednisolone after ACDF appears to be effective in relieving dysphagia and decreasing the PSTS. Furthermore, the short-term use of methylprednisolone was not associated with any adverse effects of short-term IV steroid usage, such as peptic ulcer disease or postoperative infection. The clinical use of methylprednisolone in relieving dysphagia and decreasing PSTS deserves consideration during the early postoperative period.
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk 561-712 Korea.
authors.forename: Kyung-Jin
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk 561-712 Korea. Electronic address: lsk0107@hanmail.net.
authors.forename: Su-Kyung
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk 561-712 Korea.
authors.forename: Jong-Hyun
authors.initials: JH
authors.lastname: Ko
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk 561-712 Korea.
authors.forename: Myung-Jae
authors.initials: MJ
authors.lastname: Yoo
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk 561-712 Korea.
authors.forename: Do-Yeon
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk 561-712 Korea.
authors.forename: Kwang-Bok
authors.initials: KB
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D003680:Deglutition Disorders / Q000188:drug therapy / Q000209:etiology; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D004487:Edema / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*
chemical_list: D008775:Methylprednisolone
keywords: Adverse effects; Anterior cervical discectomy and fusion (ACDF); Dysphagia; Methylprednisolone; Prevertebral soft-tissue swelling (PSTS); Short-term IV usage