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The retropharyngeal steroid use during operation on the fusion rate and dysphagia after ACDF? A systematic review and meta-analysis

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.

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Availability of data and materials

The data analyzed during the current meta-analysis are available from the corresponding author on reasonable request.

Abbreviations

ACDF:

Anterior cervical discectomy and fusion

PEEK:

Polyetheretherketone

NOS:

Newcastle–Ottawa scale

SD:

Standard deviation

VAS:

Visual analog scale

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Authors

Contributions

MST and PY developed the protocol and involved in the design, selection of study, data extraction, and statistical analysis and developing the initial drafts of the manuscript. FY, LG, YS and XST involved in data extraction, quality assessment, statistical analysis and revising. JPS and YLW prepared the final draft of the manuscript. All authors read and approved the final draft of the manuscript.

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Correspondence to Mingsheng Tan.

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Song, J., Yi, P., Wang, Y. et al. The retropharyngeal steroid use during operation on the fusion rate and dysphagia after ACDF? A systematic review and meta-analysis. Eur Spine J 31, 288–300 (2022). https://doi.org/10.1007/s00586-021-06727-1

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  • DOI: https://doi.org/10.1007/s00586-021-06727-1

Keywords

  • Anterior cervical discectomy and fusion
  • Retropharyngeal steroid use
  • Fusion rate
  • Dysphagia