AUTHOR=Zhang Xiang , Yang Yi , Shen Yi-Wei , Zhang Ke-Rui , Ma Li-Tai , Liu Hao 

TITLE=Effect of perioperative steroids application on dysphagia, fusion rate, and visual analogue scale (VAS) following anterior cervical spine surgery: A meta-analysis of 14 randomized controlled trials (RCTs)

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1040166

DOI=10.3389/fsurg.2022.1040166

ISSN=2296-875X

ABSTRACT=<sec><title>Objective</title><p>To conduct a high-level meta-analysis of the RCTs to evaluate perioperative steroids use in the management of fusion rate, dysphagia, and VAS following anterior cervical spine surgery for up to 1 year.</p></sec><sec><title>Methods</title><p>We searched the database PubMed, EMBASE, Web of Science, Cochrane Library, Google Scholar, Ovid, and <ext-link ext-link-type="uri" xlink:href="ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> without time restriction to identify RCTs that evaluate the effectiveness of perioperative steroids after anterior cervical spine surgery. A subgroup analysis was undertaken to investigate the effects of intravenous and local steroids. This study was registered in the PROSPERO database prior to initiation (CRD42022313444).</p></sec><sec><title>Results</title><p>A total of 14 RCTs were eligible for final inclusion. This meta-analysis showed that steroids could achieve lower dysphagia rate (<italic>p</italic> &lt; 0.001), severe dysphagia rate within 1 year (<italic>p</italic> &lt; 0.001), lower VAS scores at both 1 day (<italic>p</italic> = 0.005), 2 weeks (<italic>p</italic> &lt; 0.001) and shorter hospital stay (<italic>p</italic> = 0.014). However, there was no significant difference between the two groups regarding operation time (<italic>p</italic> = 0.670), fusion rates (<italic>p</italic> = 0.678), VAS scores at 6 months (<italic>p</italic> = 0.104) and 1 year (<italic>p</italic> = 0.062). There was no significant difference between intravenous and local steroid administration regarding dysphagia rates (<italic>p</italic> = 0.82), fusion rate (<italic>p</italic> = 1.00), and operative time (<italic>p</italic> = 0.10).</p></sec><sec><title>Conclusion</title><p>Steroids intravenously or locally following anterior cervical spine surgery can reduce incidence and severity of dysphagia within 1 year, VAS score within 2 weeks, and shorten the length of hospital stay without affecting fusion rates, increasing the operating time, VAS score at 6 months and 1 year.</p></sec>