Perioperative Intravenous Corticosteroids and Radiographic Prevertebral Soft Tissue Swelling in Anterior Cervical Fusion for Degenerative Disease.

Perioperative Intravenous Corticosteroids and Radiographic Prevertebral Soft Tissue Swelling in Anterior Cervical Fusion for Degenerative Disease.

World Neurosurg. 2019 Feb 07;:

Authors: Yi JL, Glover M, Charitable J, Ramcharran H, Kurra S, Tallarico R, Sun M, Lavelle WF

Abstract
OBJECTIVE: Prevertebral soft tissue swelling (PSTS) is a known complication of anterior cervical fusion (ACF). Prior studies have shown perioperative steroids may reduce PSTS following ACF. We retrospectively evaluated the role of perioperative IV corticosteroid administration in minimizing radiographic PSTS measurements in patients receiving ACF for degenerative disease.
METHODS: Records of 100 consecutive patients receiving ACF for degenerative disease (CPT code 63075) from January 2010 through December 2012 by two orthopedic spine fellowship-trained surgeons at a single institution retrospectively reviewed. Patients were included based upon specific criteria. They were then separated into comparison and IV steroid groups. Demographic and surgical parameters were collected. Lastly, measurements of PSTS, which included PSTS ratio and PSTSI, were obtained from plain radiographs preoperatively and at three postoperative time points.
RESULTS: Eighty patients were included: 26 received IV steroids at the surgeon's discretion (12 intraoperatively, 11 postoperatively and 3 at both time periods). With the exception of history of prior anterior cervical spine surgery (3.70% comparison vs. 23.08% IV steroid, p=0.01), there was no statistically significant demographic parameter. Furthermore, there was no statistically surgical parameter. Lastly, there was no statistically significant difference between groups at any time point for either PSTS ratio at any level or PSTSI.
CONCLUSION: There does not appear to be a role for perioperative IV steroid administration in minimizing radiographic PSTS in patients undergoing ACF for degenerative disease. The relationship between perioperative IV steroid administration and PSTS requires further investigation.

PMID: 30738939 [PubMed - as supplied by publisher]

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