PMID- 22020609
OWN - NLM
STAT- MEDLINE
DCOM- 20120511
LR  - 20220408
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 36
IP  - 26
DP  - 2011 Dec 15
TI  - Effect of retropharyngeal steroid on prevertebral soft tissue swelling following 
      anterior cervical discectomy and fusion: a prospective, randomized study.
PG  - 2286-92
LID - 10.1097/BRS.0b013e318237e5d0 [doi]
AB  - STUDY DESIGN: A prospective, randomized study. OBJECTIVE: 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 PSTS. 
      METHODS: 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, 
      Neck Disability Index 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 
      (the 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 Visual Analogue Scale 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. CONCLUSION: 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.
FAU - Lee, Sang-Hun
AU  - Lee SH
AD  - Department of Orthopedic Surgery, Spine Center, Kyung Hee University East-West 
      Neo Medical Center, Seoul, Korea.
FAU - Kim, Ki-Tack
AU  - Kim KT
FAU - Suk, Kyung-Soo
AU  - Suk KS
FAU - Park, Kyoung-Jun
AU  - Park KJ
FAU - Oh, Kyung-Il
AU  - Oh KI
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
RN  - 0 (Glucocorticoids)
RN  - 1ZK20VI6TY (Triamcinolone)
SB  - IM
MH  - Cervical Vertebrae/pathology/*surgery
MH  - Deglutition Disorders/etiology/prevention & control
MH  - Diskectomy/*adverse effects
MH  - Edema/diagnostic imaging/etiology/*prevention & control
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Pharynx
MH  - Prospective Studies
MH  - Radiography
MH  - Spinal Fusion/*adverse effects
MH  - Time Factors
MH  - Treatment Outcome
MH  - Triamcinolone/*therapeutic use
EDAT- 2011/10/25 06:00
MHDA- 2012/05/12 06:00
CRDT- 2011/10/25 06:00
PHST- 2011/10/25 06:00 [entrez]
PHST- 2011/10/25 06:00 [pubmed]
PHST- 2012/05/12 06:00 [medline]
AID - 10.1097/BRS.0b013e318237e5d0 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2011 Dec 15;36(26):2286-92. doi: 
      10.1097/BRS.0b013e318237e5d0.