This article is more than 5 years old. Information may no longer be current.

Study links intraoperative corticosteroids in gel matrix with reduced dysphagia after ACDF

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Todd J. Albert

CHICAGO — Local intraoperative steroids to prophylactically reduce dysphagia postoperatively in patients who undergo multilevel anterior cervical discectomy and fusion were effective at postoperative day 2, according to a presenter at the North American Spine Society Annual Meeting.

Furthermore, these results were maintained at 1 month postoperatively, according to Todd J. Albert, MD, FAAOS, who said that until now it was not proven whether a corticosteroid helped dysphagia, which he deemed the number one issue with anterior cervical discectomy and fusion (ACDF).

Investigators used either 1 mL (40 mg) of the steroid – methylprednisolone – in a gel matrix in the 48 treated patients or the gel matrix alone in the 47 control patients after two- to four-level ACDF. These patients, who had a complete dataset, were followed up using three typical, validated dysphagic outcome measures through 1 month postoperatively to measure swallowing and to assess outcomes.

“[Neither] the investigator nor the patient knew what they received until a year after treatment,” Albert said.

The patients were well-matched demographically, he noted.

“What we found were significant improvements in the steroid group both at postop day 2, looking at the control vs. the steroid group, and 1 month in the control vs. the steroid group,” Albert said.

Among improvements the investigators observed were better eating desire and less fear of swallowing, he said.

“We found the control arm had greater swallowing problems immediately at postop day 2 and in the early follow-up period based on these validated outcome scores in this study,” said Albert, who is an Orthopedics Today Editorial Board Member.

“Our study demonstrates, I believe for the first time, using a validated methodology, the benefit of local intraoperative corticosteroids delivered in a gel matrix in reducing dysphagia following multilevel ACDFs,” he said, noting the investigators plan further follow-up to determine the impact of fusion on these patients and their risk for dysphagia. – by Susan M. Rapp

Reference:

Stein D. et al. Abstract 37. Presented at: North American Spine Society Annual Meeting; Sept. 25-28, 2019; Chicago.

Disclosure: Albert reports he has stock or stock options with ASIP, Biometrix, Breakway Imaging, Crosstree, In ViVo Therapeutics, Invuity, Paradigm Spine, PMIG, Spinicity and Vertech; receives IP royalties from Biomet; receives IP royalties from and is a paid consultant for DePuy, A Johnson & Johnson Company; is a paid consultant for and has stock or stock options with FacetLink; is a paid consultant for and has stock or stock options with Gentis; and is a paid consultant for NuVasive.