The Effects of Perioperative Corticosteroids on Dysphagia Following Surgical Procedures Involving the Anterior Cervical Spine

Cui, Shari; Daffner, Scott D.; Emery, Sanford E.

doi:10.2106/jbjs.19.00198

Cited by 22 publications

(21 citation statements)

References 19 publications

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“…The assessments of dysphagia in this retrospective study were based on the subjective experience by patients. Most patients presented with dysphagia after operation lack anatomical examinations such as barium meal test, and laryngoscopy 18 . In the future, prospective studies with larger samples are required to achieve more reliable conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Tao

2020

Preprint

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Tao

2020

Preprint

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“…When compared to the control group, both local and IV steroids dramatically reduced dysphagia symptoms. In a study by Cui et al, 18) 33 patients undergoing multilevel anterior cervical spine surgery were given three doses of dexamethasone (0.3 mg/kg before incision and 0.15 mg/kg at 8 and 16 hours postoperatively) and reported less dysphagia than a group of 31 patients who received a placebo. Benefits were noticed right away and for up to 6 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of Single-Dose Preemptive Systemic Dexamethasone on Postoperative Dysphagia and Odynophagia Following Anterior Cervical Spine Surgery: A Double-Blinded, Prospective, Randomized Controlled Trial

et al. 2022

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“… 40 The use of corticosteroids perioperatively in anterior cervical spine surgery has however shown benefit in reducing post-operative complications with significant reduction in airway oedema, pain, hospital stay and improved swallowing in Phase-III randomized controlled trials. 41 , 42 This surgical approach is used in the surgical management of DCM and future studies should look into the potential functional benefits of corticosteroids in these patients.…”

Section: Neuroprotectionmentioning

confidence: 99%

Developing Novel Therapies for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 7]: Opportunities From Restorative Neurobiology

Gharooni

Fehlings

Boerger

et al. 2022

Global Spine Journal

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Study design Narrative review. Objectives To provide an overview of contemporary therapies for the James Lind Alliance priority setting partnership for degenerative cervical myelopathy (DCM) question: ‘Can novel therapies, including stem-cell, gene, pharmacological and neuroprotective therapies, be identified to improve the health and wellbeing of people living with DCM and slow down disease progression?’ Methods A review of the literature was conducted to outline the pathophysiology of DCM and present contemporary therapies that may hold therapeutic value in 3 broad categories of neuroprotection, neuroregeneration, and neuromodulation. Results Chronic spinal cord compression leads to ischaemia, neuroinflammation, demyelination, and neuronal loss. Surgical intervention may halt progression and improve symptoms, though the majority do not make a full recovery leading to lifelong disability. Neuroprotective agents disrupt deleterious secondary injury pathways, and one agent, Riluzole, has undergone Phase-III investigation in DCM. Although it did not show efficacy on the primary outcome modified Japanese Orthopaedic Association scale, it showed promising results in pain reduction. Regenerative approaches are in the early stage, with one agent, Ibudilast, currently in a phase-III investigation. Neuromodulation approaches aim to therapeutically alter the state of spinal cord excitation by electrical stimulation with a variety of approaches. Case studies using electrical neuromuscular and spinal cord stimulation have shown positive therapeutic utility. Conclusion There is limited research into interventions in the 3 broad areas of neuroprotection, neuroregeneration, and neuromodulation for DCM. Contemporary and novel therapies for DCM are now a top 10 priority, and whilst research in these areas is limited in DCM, it is hoped that this review will encourage research into this priority.

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The Effects of Perioperative Corticosteroids on Dysphagia Following Surgical Procedures Involving the Anterior Cervical Spine

Cited by 22 publications

References 19 publications

Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Effect of Single-Dose Preemptive Systemic Dexamethasone on Postoperative Dysphagia and Odynophagia Following Anterior Cervical Spine Surgery: A Double-Blinded, Prospective, Randomized Controlled Trial

Developing Novel Therapies for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 7]: Opportunities From Restorative Neurobiology

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