Steroid administration has been suggested as a possible treatment for post-operative dysphagia, which is a common early adverse event following anterior cervical surgery. Patients (N=112) were randomized in a 1:1 ratio to receive saline or dexamethasone with clinical and radiological follow-up over 24 months. Swallowing function, as assessed by the Functional Outcome Swallowing Scale, was significantly improved at one month as compared to placebo (p = 0.027) but at none of the other time points up to 24 months. A trend toward significance (p=0.057) in the placebo group was also noted for airway difficulty and the need for re-intubation. Of note, while the rate of fusion (as assessed on CT) was reduced in the steroid group (37.8% versus 60%; p = 0.046) at 6 months, the differences were no longer significant at 12 and 24 months. Taken together, this study provides evidence for the use of steroids following anterior cervical surgery to reduce rates of early dysphagia without affecting long-term fusion rates.
Journal of Neurosurgery