Intravenous Corticosteroid Before Spinal Surgery Improves Clinical Outcomes Compared to Placebo .
Can Preoperative Intravenous Corticosteroids Administration Reduce Postoperative Pain Scores Following Spinal Fusion?: A Meta-Analysis.
J Invest Surg. 2020 Apr;33(4):307-316.A total of 10 randomized controlled trials containing 998 patients undergoing spinal fusion surgery were included in this meta-analysis comparing the treatment of pre-operative intravenous corticosteroids or placebo. The primary pooled outcome of interest was pain on a Visual Analogue Scale (VAS) post-operation. Additional pooled outcomes included the post-operative nausea occurrence, the incidence of infection, total morphine consumption, and length of hospital stay post-spinal fusion surgery. For the primary outcome, the results showed statistically significantly favourable pooled scores in the corticosteroid group compared to the placebo at all timepoints (12, 24, 48, 72-hours post-surgery) and overall (p<0.00001). Similar results were found for all other outcomes including postoperative nausea occurrence, total morphine consumption, length of hospital stay (all p<0.00001), except for the incidence of infection (p=0.57). Furthermore, subgroup analyses were conducted for high-dose (≥10 mg) to low-dose (<10 mg) corticosteroids for VAS pain at 12-hours post-surgery: pooled scores were statistically significantly favorable in the corticosteroid group (p=0.001 for both).
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