Does Local Steroid Reduce Dysphagia After Cervical Disc Replacement? A Prospective, Randomized, Placebo-controlled,...

Area of Science:

• Neurosurgery
• Anesthesiology
• Pharmacology

Background:

• Postoperative dysphagia is a common complication following anterior cervical surgeries.
• Topical corticosteroids have shown promise in reducing dysphagia after anterior cervical discectomy and fusion.
• No prior studies have investigated the impact of local steroids on dysphagia after cervical disk replacement (CDR).

Purpose of the Study:

• To evaluate the efficacy of intraoperatively administered local Depo-Medrol in mitigating the incidence and severity of postoperative dysphagia in patients undergoing CDR surgery.

Main Methods:

• A prospective, randomized, placebo-controlled, double-blinded study involving 73 patients undergoing CDR.
• A collagen sponge saturated with either Depo-Medrol or saline was placed in the retroesophageal space.
• Dysphagia was assessed using the Bazaz Dysphagia Score and Eating Assessment Tool 10 at multiple postoperative time points.

Main Results:

• The Depo-Medrol group demonstrated a significantly lower incidence of dysphagia (50% vs. 75%) and severe dysphagia (12% vs. 36% Bazaz score; 18% vs. 42% Eating Assessment Tool 10) at postoperative day 4.
• No significant long-term differences in dysphagia rates were observed between the groups.

Conclusions:

• Intraoperative local Depo-Medrol provides level 1 evidence for significantly reducing early postoperative dysphagia after CDR.
• Local steroid application may enhance early recovery by improving the swallowing experience for patients undergoing CDR surgery.