title: Effect of perioperative steroids on dysphagia after anterior cervical spine surgery: A systematic review.
abstract: BACKGROUND
  Dysphagia following anterior cervical spine surgery is common. Steroids potentially reduce post-operative inflammation that leads to dysphagia; however, the efficacy, optimal dose and route of steroid administration have not been fully elucidated.
  
  
  OBJECTIVE
  The purpose of this systematic review is to evaluate the effect of peri-operative steroids on the incidence and severity of dysphagia following anterior cervical spine surgery.
  
  
  METHODS
  A PubMed search adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to include clinical studies reporting use of steroids in adult patients following anterior cervical spine surgery. Data regarding steroid dose, route and timing of administration were abstracted. Incidence and severity of post-operative dysphagia were pooled across studies.
  
  
  RESULTS
  Seven of 72 screened articles met inclusion criteria for a total of 246,298 patients that received steroids. Patients that received systemic and local steroids had significant reductions in rate and severity of dysphagia postoperatively. Reduction of dysphagia severity was more pronounced in patients undergoing multilevel procedures in both groups. There was no difference in infectious complications among patients that received steroids compared with controls. There was no difference in fusion rates at long-term follow-up.
  
  
  CONCLUSIONS
  Steroids may reduce dysphagia after anterior cervical spinal procedures in the early post-operative period without increasing complications. This may be especially beneficial in patients undergoing multilevel procedures. Future studies should further define the optimal dose and route of steroid administration, and the specific contraindications for use.
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Abidemi S
authors.initials: AS
authors.lastname: Adenikinju
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Sameer H
authors.initials: SH
authors.lastname: Halani
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Rima S
authors.initials: RS
authors.lastname: Rindler
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Gary
authors.affiliation: Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Keith W
authors.initials: KW
authors.lastname: Michael
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Faiz U
authors.initials: FU
authors.lastname: Ahmad
keywords: anterior cervical spine; dysphagia; steroids