Document Detail


Effect of Retropharyngeal Steroid on Prevertebral Soft Tissue Swelling Following Anterior Cervical Discectomy and Fusion; A Prospective, Randomized Study.
MedLine Citation:
PMID:  22020609     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT: Study Design. A prospective, randomized studyObjectives. To analyze the effect of local retropharyngeal steroid to reduce prevertebral soft tissue swelling (PSTS) after anterior cervical discectomy and fusion (ACDF).Summary of Background Data. There have been several reports on intravenous corticosteroid to prevent airway complication without a consensus, however, there have been no reports to date that have discussed the use of local steroids to reduce PSTSMethods. Fifty cases that underwent ACDF involving 1 or 2 segments were enrolled. The mean follow-up period was 22 months. Of the 25 cases randomly selected as the steroid group, a mixture of triamcinolone and morcellized collagen sponge was applied to the retropharyngeal space before wound closure. For the control group, the other 25 cases received the operation without steroid. We measured the PSTS ratio to vertebral body from C3 to 7 and PSTS index (PSTSI; mean of PSTS ratio at C3, 4, and 5) on cervical spine. Simple lateral radiographs were taken preoperatively, immediately after operation, and at postoperative 2 days, 4 days, 2 weeks and the last follow-up. The changes in odynophagia, radiological union, NDI were analyzed.Results. The PSTS ratio of the steroid group was significantly lower on C3 and C4 immediately after operation, on C3, 4, 5 and C6 at postoperative 2 days, on C3, 4, and 5 at 4 days. The differences of PSTSI (steroid: control group) maintained at 58.2: 74.3% (p = 0.004) immediately after operation, 57.9: 84.1% (p = 0.000) at 2 days, 56.3: 82.9% (p = 0.000) at 4 days, and 44.9: 51.4% (p = 0.037) at 2 weeks. The mean VAS for odynophagia was significantly lower in the steroid group until postoperative 2 weeks. The last follow-up showed no significant difference in the radiological and clinical outcome.Conclusions. Using the retropharyngeal local steroid, we significantly reduced PSTS and odynophagia following ACDF without additional complication. This method may be considered a simple and effective method to decrease PSTS following anterior cervical spine surgery.
Authors:
Sang-Hun Lee; Ki-Tack Kim; Kyung-Soo Suk; Kyoung-Jun Park; Kyung-Il Oh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-20
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Orthopedic Surgery, Spine center, Kyung Hee University, East-West Neo Medical Center Department of Orthopedic Surgery, Kyung Hee University, Seoul, Korea.
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