Topical steroids may reduce dysphagia after anterior cervical discectomy and fusion
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Local intraoperative corticosteroids administered after anterior cervical discectomy and fusion may be effective in reducing swallowing difficulties, according to published results.
Daniel Stein, BS, and colleagues at Hospital for Special Surgery analyzed postoperative outcomes for 95 patients who underwent multilevel anterior cervical discectomy and fusion (ACDF) in a prospective, randomized, double-blind, control trial.
“Arm S (Steroid) received 1 mL (40 mg) of methylprednisolone delivered with an absorbable hemostatic matrix (vehicle) to the retro-esophageal space prior to closure. The control arm (C) only received the vehicle prior to closure,” Stein and colleagues wrote in the abstract.
Dysphagia instruments the Eating Assessment Tool-10 (EAT-10) and Swallowing Quality of Life questionnaire (SWAL-QOL) were collected before surgery, at 1 day after operation (POD1), 2 days after operation (POD2) and 1 month after operation (M1).
Stein and colleagues found the steroid group had “significantly better” dysphagia scores than the control group.
According to the abstract, at POD1, the steroid group received better SWAL-QOL scores in food selection and fear of swallowing. At POD2, the steroid group received better dysphagia scores in burden, eat duration, fear of swallowing, fatigue and EAT-10. At M1, the steroid group received better dysphagia scores in eat desire, eat duration, fear of swallowing and fatigue.
“Our study demonstrated the benefit of [local intraoperative corticosteroids] with this delivery method to prophylactically reduce dysphagia following ACDFs,” Stein and colleagues wrote. “Early postop results were superior for treatment group – especially postop days 2 – and maintained at 1 month,” they concluded.
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Stein D, et al. Poster 678. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
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