title: The role of steroid administration in the management of dysphagia in anterior cervical procedures.
abstract: Dysphagia is a common postoperative symptom for patients undergoing anterior cervical spine procedures. The purpose of this study is to present the current literature regarding the effect of steroid administration in dysphagia after anterior cervical spine procedures. We performed a literature search in the PubMed database, using the following terms: "dysphagia," "ACDF," "cervical," "surgery," "anterior," "spine," "steroids," "treatment," and "complications." We included in our review any study correlating postoperative dysphagia and steroid administration in anterior cervical spine surgery. Studies, which did not evaluate, pre- and postoperatively, dysphagia with a specific clinical or laboratory methodology were excluded from our literature review. Five studies were included in our results. All were randomized, prospective studies, with one being double blinded. Steroid administration protocol was different in every study. In two studies, dexamethasone was used. Methylprednisolone was administrated in three studies. In four studies, steroids were applied intravenously, while in one study, locally in the retropharyngeal space. Short-term dysphagia and prevertebral soft tissue edema were diminished by steroid administration, according to the results of two studies. In one study, prevertebral soft tissue edema was not affected by the steroid usage. Furthermore, short-term osseous fusion rate was impaired by the steroid administration, according to the findings of one study. The usage of steroids in patients undergoing anterior cervical spine procedures remains controversial. Multicenter, large-scale, randomized, prospective studies applying the same protocol of steroid administration and universal outcome criteria should be performed for extracting statistically powerful and clinically meaningful results.
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA. isiasios@ubns.com.|University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY, 14203, USA. isiasios@ubns.com.|Department of Neurosurgery, Kaleida Health, Buffalo, NY, USA. isiasios@ubns.com.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Siasios
authors.affiliation: Department of Neurosurgery, School of Medicine, University of Thessaly, Larisa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Fountas
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, Kaleida Health, Buffalo, NY, USA.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Dimopoulos
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.|Department of Neurosurgery, Kaleida Health, Buffalo, NY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Pollina
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery*; D003680:Deglutition Disorders / Q000188:drug therapy* / Q000209:etiology; D017586:Diskectomy / Q000009:adverse effects* / Q000379:methods; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D011446:Prospective Studies; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods
chemical_list: D005938:Glucocorticoids
keywords: Anterior; Cervical spine; Dysphagia; Soft tissue edema; Steroids