• World Neurosurg · May 2019

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

    • Juneyoung L Yi, Michael Glover, John Charitable, Harry Ramcharran, Swamy Kurra, Richard A Tallarico, Mike H Sun, and William F Lavelle.
    • Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, USA.
    • World Neurosurg. 2019 May 1; 125: e784-e789.

    ObjectivePrevertebral soft tissue swelling (PSTS) is a known complication of anterior cervical fusion (ACF). Prior studies have shown that perioperative steroids may reduce PSTS after ACF. We retrospectively evaluated the role of perioperative intravenous (IV) corticosteroid administration in minimizing radiographic PSTS measurements in patients undergoing ACF for degenerative disease.MethodsRecords of 100 consecutive patients undergoing ACF for degenerative disease (Current Procedural Terminology code 63075) from January 2010 through December 2012 by 2 orthopedic spine fellowship-trained surgeons at a single institution were retrospectively reviewed. Patients were included on the basis of specific criteria. They were then separated into comparison and IV steroid groups. Demographic and surgical data were collected. Last, measurements of PSTS, which included PSTS ratio and PSTS index (PSTSI), were obtained from plain radiographs preoperatively and at 3 postoperative time points.ResultsEighty 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 a history of prior anterior cervical spine surgery (3.70% comparison vs. 23.08% IV steroid, P = 0.01), there was no statistically significant demographic characteristic. Furthermore, there was no statistically significant surgical characteristic. Last, there was no statistically significant difference between groups at any time point for either PSTS ratio at any level or PSTSI.ConclusionsThere 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.Copyright © 2019 Elsevier Inc. All rights reserved.

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