Jipeng Song1,2,3, Ping Yi2, Yanlei Wang2,4, Long Gong1,2, Yan Sun2,4, Feng Yang2, Xiangsheng Tang2, Mingsheng Tan5,6. 1. Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. 2. Department of Spinal Surgery, China-Japan Friendship Hospital, 2 Yinghuayuan Dongjie, Beijing, 100029, People's Republic of China. 3. Department of Spinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China. 4. Graduate School of Beijing University of Chinese Medicine, Beijing, People's Republic of China. 5. Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. zrtanms@sina.com. 6. Department of Spinal Surgery, China-Japan Friendship Hospital, 2 Yinghuayuan Dongjie, Beijing, 100029, People's Republic of China. zrtanms@sina.com.
Abstract
PURPOSE: The aim of this meta-analysis was to investigate the effects of retropharyngeal steroid use during operation on bony fusion and dysphagia rate after ACDF. METHODS: We searched the electronic literature database of PubMed, Embase and the Cochrane Library published from January 1990 to February 2020. The size of each group, mean age, proportion of female patients, dysphagia events and fusion rate at one-year follow-up were extracted. RevMan 5.3 was used for the meta-analysis. RESULTS: A total of eight studies including six RCTs and two case-control studies met the inclusion criteria. This meta-analysis showed that retropharyngeal steroids could achieve significantly lower dysphagia rates (p < 0.001), higher fusion rates (p = 0.01), less moderate and severe events rates according to the Bazaz stratification (p < 0.001). However, there was no significant difference between two groups regarding operation time (p = 0.67), blood loss (p = 0.33), VAS scores at one day (p = 0.90) and VAS scores at two weeks (p = 0.80). CONCLUSIONS: Retropharyngeal steroid use is an effective method in reducing dysphagia rate, severe dysphagia rate and increasing fusion rate during ACDF surgery, without increasing operating time, blood loss or VAS scores at one day and two weeks. LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.
PURPOSE: The aim of this meta-analysis was to investigate the effects of retropharyngeal steroid use during operation on bony fusion and dysphagia rate after ACDF. METHODS: We searched the electronic literature database of PubMed, Embase and the Cochrane Library published from January 1990 to February 2020. The size of each group, mean age, proportion of female patients, dysphagia events and fusion rate at one-year follow-up were extracted. RevMan 5.3 was used for the meta-analysis. RESULTS: A total of eight studies including six RCTs and two case-control studies met the inclusion criteria. This meta-analysis showed that retropharyngeal steroids could achieve significantly lower dysphagia rates (p < 0.001), higher fusion rates (p = 0.01), less moderate and severe events rates according to the Bazaz stratification (p < 0.001). However, there was no significant difference between two groups regarding operation time (p = 0.67), blood loss (p = 0.33), VAS scores at one day (p = 0.90) and VAS scores at two weeks (p = 0.80). CONCLUSIONS: Retropharyngeal steroid use is an effective method in reducing dysphagia rate, severe dysphagia rate and increasing fusion rate during ACDF surgery, without increasing operating time, blood loss or VAS scores at one day and two weeks. LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.
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Authors: Luiz Gustavo Dal Oglio da Rocha; Victoria Stadler Tasca Ribeiro; Ana Paula de Andrade; Geiziane Aparecida Gonçalves; Letícia Kraft; Juliette Cieslinski; Paula Hansen Suss; Felipe Francisco Tuon Journal: Eur J Orthop Surg Traumatol Date: 2021-07-08