The Effect of Local Versus Intravenous Corticosteroids on the Likelihood of Dysphagia and Dysphonia Following Anterior Cervical Discectomy and Fusion

Jenkins, Tyler J.; Nair, Rueben; Bhatt, Surabhi; Rosenthal, Brett D.; Savage, Jason W.; Hsu, Wellington K.; Patel, Alpesh A.

doi:10.2106/jbjs.17.01540

Cited by 39 publications

(81 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many potential risk factors have been reported, including age 1,2 , gender 3,4 , intraoperative esophagus traction 5,6 , long segmental surgery 7,8 , postoperative persistent pain 9,10 , prolonged procedure time 11 , high surgical position 12 , revision surgery 13 , esophageal intubation , and massive blood loss 15 . In addition, other risk factors were associated with dysphagia development such as thickness of internal plate 16 , intraoperative injury of esophagus 17 , postoperative cervical hematoma formation 18 , the use of BMP-2 19 , postoperative soft swelling 20 , scar formation and tissue adhesion 21 , internal compression of the esophagus 22 and recurrent laryngeal nerve injury [23][24][25] .…”

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Tao

2020

Preprint

View full text Add to dashboard Cite

Background. Dysphagia is a known complication of anterior cervical spine surgery and may be prolonged or occasionally serious. However, the association between posterior cervical spine surgery and the development of dysphagia is rare discussed. Furthermore, the risk factors of postoperative dysphagia are not well understood.Methods. Three hundred and fifty four patients were reviewed in this study, including 172 patients undergoing AC procedure, and 182 patients with PC procedure between June 2007 and May 2012. All patients were given the same postoperative management. The presence and severity of dysphagia were reported during the telephone interviews performed at 1, 3, 6, and 12 months after the procedure. The incidence and risk factors of dysphagia after cervical spine surgery were studied. Results. Of all 354 patients, 12.8% AC and 9.4% PC patients reported dysphagia at early postoperative assessment. The overall incidence for dysphagia at 1, 3, 6 and 12 months were decreased to 9.3%, 7.0%, 4.6% and 3.5% in AC group, and 6.0%, 4.4%, 2.2% and 1.6% in PC group, respectively. Long term use of Neck Collar after surgery may lead to postoperative dysphagia. Other risk factors such as age, gender, BMI, operative time, blood loss, procedure type, revision surgery and operative levels did not signiﬁcantly influence the incidence of postoperative dysphagia.Conclusions. Postoperative dysphagia is common after anterior and posterior cervical spine surgery. The incidence and severity of dysphagia both decrease over time. Long term use of neck collar after surgery is related of postoperative dysphagia. The neck collar should be worn no longer than four weeks after surgery. Age, gender, BMI, operative time, blood loss, procedure type, revision surgery and operative levels are not risk factors of postoperative dysphagia.

show abstract

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Tao

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In study of Jenkins et al (21), both IV and local steroid groups had significantly less severe dysphagia and neck pain than the control group. Additionally, the patients in local steroid group showed better outcomes of dysphagia and neck pain than these in IV steroid group.…”

Section: The Role and Effect Of Corticosteroidsmentioning

confidence: 86%

“…Lee et al (25) reported two delayed esophageal perforation cases who underwent anterior cervical spine surgery and retropharyngeal local steroid use. In study of Jenkins et al (21), although without complications of surgical infection and esophageal injuries were observed, both two patients with nonunion are belong to the local steroid group, none of patients with nonunion in two other groups. Give to the lower incidence of nonunion and other complication, the limited number of included patients still can't provide powder enough analysis to permit a significant difference.…”

Section: The Role and Effect Of Corticosteroidsmentioning

confidence: 90%

“…Recently, the Jenkins et al (21) conducted a singleblinded, prospective randomized controlled trial to compare local or intravenous corticosteroids vs. placebo on the likelihood of dysphagia and dysphonia following anterior cervical discectomy and fusion. Total of 75 patients were randomized assigned into three different groups of control (placebo without steroid, N=21), IV (intravenous) steroid (IV 10 mg dexamethasone at the time of closure, N=25), and local steroid (local 40 mg triamcinolone, N=29).…”

Section: The Role and Effect Of Corticosteroidsmentioning

confidence: 99%

“…In summary, the study of Jenkins et al (21) is a welldesigned clinical trial, provides novel knowledge of the effect of IV and local steroid use to prevent the postoperative dysphagia and dysphonia. The results of this study also may change the clinical practice of spine surgeons.…”

Section: The Role and Effect Of Corticosteroidsmentioning

confidence: 99%

See 2 more Smart Citations

Current strategies of reduce the rate of dysphagia and dysphonia after anterior cervical spine surgery and role of corticosteroids

et al. 2018

View full text Add to dashboard Cite

The effect of local steroid application on bony fusion in a rat posterolateral spinal arthrodesis model

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction: Local steroid administration during anterior cervical spine surgery has been shown to improve postoperative dysphagia. However, concerns over potential complications remain. This study aims to evaluate the effect of local steroid administration on bone regeneration and spine fusion in a preclinical model, as well as the impact on osteogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBM-MSCs) in a 3D culture system.Materials and methods: Forty-five rats underwent bilateral L4-L5 posterolateral lumbar fusion (PLF) utilizing local delivery of low-dose recombinant human bone morphogenetic protein-2 (rhBMP-2; 0.5 μg/implant). Rats were divided into three groups: no steroid (control), low dose (0.5 mg/kg), and high dose (2.5 mg/kg) of triamcinolone. Bone growth and fusion were assessed using radiography, blinded manual palpation, and micro-CT analysis and were visualized by histology. The impact of triamcinolone exposure on osteogenic differentiation of hBM-MSCs was evaluated by gene expression analysis, alkaline phosphatase activity assay, and alizarin red staining.Results: No significant differences in fusion scores or rates were seen in the low-or high-dose steroid treatment groups relative to untreated controls. Quantification of new bone formation via micro-CT imaging revealed no significant between-group differences in the volume of newly regenerated bone. Triamcinolone also had no negative impact on pro-osteogenic gene transcript levels, and ALP activity was enhanced in the presence of triamcinolone. Mineral deposition appeared comparable in cultures grown with and without triamcinolone.Conclusions: Local steroid application does not seem to inhibit rhBMP-2-mediated spine fusion in rats, though our study may not be adequately powered to detect differences in fusion as measured by manual palpation or bone volume as measured by Abhishek Kannan and Silvia Minardi contributed equally to this study.

show abstract

The Effect of Local Versus Intravenous Corticosteroids on the Likelihood of Dysphagia and Dysphonia Following Anterior Cervical Discectomy and Fusion

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 39 publications

References 33 publications

Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Current strategies of reduce the rate of dysphagia and dysphonia after anterior cervical spine surgery and role of corticosteroids

The effect of local steroid application on bony fusion in a rat posterolateral spinal arthrodesis model

Contact Info

Product

Resources

About