Perioperative Corticosteroids Reduce Dysphagia Severity Following Anterior Cervical Spinal Fusion: A Meta-Analysis of Randomized Controlled Trials
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(13):15 J Bone Joint Surg Am. 2021 May 5;103(9): 821-828.What this means for my practice?
The results of this meta-analysis suggest that the use of corticosteroids, in both systemic and local formulations, can significantly reduce the severity of dysphagia following anterior cervical spine procedures, with no notable increase in the risk of complications. However, the small number of included studies and patients used for the quantitative analysis, as well as the variation in type, route and dosage of corticosteroids used across the studies, are limitations of the meta-analysis. Future studies are required to confirm the results of this study and establish clear and specific recommendations on corticosteroid use in anterior cervical spine procedures.
Study Summary
Seven randomized controlled trials containing a total of 431 patients were included in this meta-analysis comparing peri-operative corticosteroid (n=247) to control (placebo or no treatment; n=184) for the reduction of the severity of post-operative dysphagia. The primary outcome of interest was the reduction of dysphagia severity. The secondary outcome of interest was the odds of complications. Pooled results revealed significantly decreased dysphagia severity in the corticosteroid group, with both systemic and local formulations, compared to control (p<0.05 for all). No significant difference in the pooled odds of complications was observed between the two groups (p=0.13).
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