Safety and Efficacy of Local Steroid Application on Dysphagia Following Anterior Cervical Discectomy and Fusion

Wang, Jun-Wu; Shi, Pengzhi; Li, Kai; Zhu, Lei; Feng, Xiaoshan; Zhang, Wenjie; Zhang, Liang

doi:10.1097/bsd.0000000000001433

Cited by 1 publication

(2 citation statements)

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“…Perioperative intravenous steroids could decrease both prevertebral swelling and the risk of airway compromise, which also decreases the risk of dysphagia after ACSS. 25,26 Our study has some limitations. First, this was a single-center retrospective analysis.…”

Section: Discussionmentioning

confidence: 93%

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Risk Factors for Reintubation After Anterior Cervical Spine Surgery

Tanaka,

Onishi,

Hashimura

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: Single-center retrospective study. Objectives: The aim was to compare the postoperative outcomes of anterior cervical spine surgery (ACSS) in patients with and without cervical spine trauma. Summary of Background: Few papers have addressed airway obstruction after anterior ACSS for patients with cervical spine trauma. This study aimed to compare airway obstruction after ACSS between patients with cervical degenerative disorders and cervical spine injuries and identify the risk factors for unplanned postoperative reintubation. Materials and Methods: Seventy-seven patients who underwent ACSS were enrolled in this retrospective study. There were 52 men and 25 women, with a mean age of 60.3±15.5 years old. The causes of surgery were as follows: 24 cervical spine fractures or dislocations, 12 spinal cord injuries without bony fracture, 19 disc herniations, and 22 myelopathies. The patients’ characteristics, operative data, and risk factors for unplanned reintubation within 5 days postoperatively were analyzed using medical records. Results: Postoperative reintubation was performed in 3 patients (3.9%), all of whom suffered trauma. We further examined risk factors for reintubation in patients in the trauma group. There was no significant difference between the reintubation (R) and nonreintubation (non-R) groups in age, sex, body mass index, amount of blood loss and operation time, preoperative paralysis severity, and the number of fused segments. Patients in group R had significantly higher rates of severe anterior element injury (100% vs. 27.3%, P=0.0011). Airway obstruction due to laryngopharyngeal edema and swelling was confirmed by laryngoscopy and computed tomography images. Conclusions: Unplanned reintubation after ACSS occurred at a higher rate in trauma patients than in patients with degenerative disorders. Our results suggested that the severe damage to the anterior element of the cervical spine was associated with postoperative reintubation. Evidence level: Level IV.

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Section: Discussionmentioning

confidence: 93%

“…Emery et al 24 recommended continuous intubation after surgery because maximal swelling occurs on the second and third postoperative days. Perioperative intravenous steroids could decrease both prevertebral swelling and the risk of airway compromise, which also decreases the risk of dysphagia after ACSS 25,26 …”

Section: Discussionmentioning

confidence: 99%