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The study systematically searched MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov for randomized controlled trials comparing corticosteroids with any comparator. Seven eligible trials (431 patients) were pooled. Moderate-quality evidence showed improved dysphagia rates with an odds ratio of 0.35, with no significant difference for intravenous versus local delivery and no documented infections or increased pseudarthrosis risk.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/perioperative-corticosteroids-reduce-dysphagia-severity-following-anterior-cervical-spinal-fusion-a-meta-analysis-of-randomized-controlled-trials/639400/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/perioperative-corticosteroids-reduce-dysphagia-severity-following-anterior-cervical-spinal-fusion-a-meta-analysis-of-randomized-controlled-trials/639400.png","ImageObject",300,407,{"name":92,"@type":93},"Hazel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-10-22",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What question does this meta-analysis address?","Question",{"text":112,"@type":113},"It determines whether perioperative corticosteroid administration reduces postoperative dysphagia severity after anterior cervical spinal procedures and whether it causes adverse effects such as pseudarthrosis or infection.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were eligible studies selected and assessed?",{"text":117,"@type":113},"The authors searched major electronic databases for randomized controlled trials and used two independent reviewers with GRADE criteria to assess eligibility, risk of bias, data extraction, and evidence quality.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the results show about dysphagia outcomes?",{"text":121,"@type":113},"Moderate-quality evidence demonstrated a significant improvement in postoperative dysphagia rates with an odds ratio of 0.35, supported by permutation and sensitivity analyses.",{"name":123,"@type":110,"acceptedAnswer":124},"Were there differences between intravenous and local steroid administration?",{"text":125,"@type":113},"No significant difference was found between intravenous and local steroid administration (p=0.16), and there were no documented infections or a significantly increased risk of pseudarthrosis (p=0.13).","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},639400,1792939535,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":46},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","Downloaded from [https://iranpaper.ir](https://iranpaper.ir)  \n821  \nCOPYRIGHT 􀀁 2021 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED  \nPerioperative Corticosteroids Reduce Dysphagia Severity Following Anterior Cervical Spinal Fusion  \nA Meta-Analysis of Randomized Controlled Trials  \nStefan Garcia, MD, Nathaniel E. Schaffer, MD, PhD, Nicholas Wallace, MD, Bilal B. Butt, MD, Joel Gagnier, ND, MSc, PhD, and  \nIlyas S. Aleem, MD, MSc, FRCSC  \nInvestigation performed at the University of Michigan, Ann Arbor, Michigan  \nBackground: The anterior approach to the cervical spine is commonly used to treat cervical pathology. It is, however, associated with high rates of dysphagia, which may be associated with substantial patient morbidity. Perioperative corticosteroid administration has been advocated to decrease dysphagia rates; its efficacy, however, remains uncertain. We conducted a meta-analysis of randomized trials to determine the efficacy of perioperative corticosteroid administration in reducing postoperative dysphagia as well as any adverse effects, such as pseudarthrosis and infection.  \nMethods: We conducted a systematic search of electronic databases (MEDLINE, Embase, CENTRAL [Cochrane Central Register of Controlled Trials], [ClinicalTrials.gov](ClinicalTrials.gov)) to identify randomized controlled trials (RCTs) that evaluated corticosteroids versus any comparator for prevention of postoperative dysphagia after anterior cervical spine procedures. Two independent reviewers used the GRADE (Grades of Recommendation Assessment, Development and Evaluation) criteria to assess eligibility and risk of bias, perform data extraction, and rate the quality of evidence. The primary outcome was severity of postoperative dysphagia. We conducted meta-analyses of dysphagia (both overall and by delivery method), pseudarthrosis, and postoperative infection.  \nResults: After screening of 927 articles, a total of 7 studies were eligible for final inclusion. These included 431 patients, of whom 247 received corticosteroids and 184 received placebo or a control treatment. Moderate-quality evidence demonstrated a significant improvement in postoperative dysphagia rates (odds ratio, 0.35; 95% confidence interval, 0.20 to 0.63; p \u003C 0.001), and this finding was robust to both permutation analyses and sensitivity analyses removing the studies with a high risk of bias. There was no significant difference between intravenous and local steroid administration (p = 0.16) . There were no documented infections. There was no significantly increased risk of pseudarthrosis in those receiving steroids compared with placebo or a control treatment (p = 0.13) .  \nConclusions: This meta-analysis found moderate-quality evidence supporting the use of perioperative corticosteroid administration as an adjunct to anterior cervical spinal procedures. Patients treated with corticosteroids intravenously or locally had significantly decreased severity of dysphagia.  \nLevel of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.  \nS ince first described by Smith and Robinson in 1958, the  \nanterior approach to the cervical spine has become the  \nstandard approach for treatment of a wide variety of cervical pathology, including decompression for cervical radiculopathy and myelopathy. This approach is relatively safe and provides adequate exposure to the middle to lower levels of the cervical spine. However, it is associated with complications such as dysphagia and dysphonia in up to 79% of patients1-5. The  \netiology of dysphagia and dysphonia after anterior cervical spinal procedures is not entirely understood, although prior investigators have postulated contributions from local tissue swelling, laryngeal nerve palsy, and prevertebral swelling. Alterations in swallowing biomechanics may lead to aspiration events and the need for speech-language therapy. Dysphagia after anterior cervical disc surgery has been demonstrated","cbCaiuFfl0lM2DbA","https://ap.wps.com/l/cbCaiuFfl0lM2DbA","pdf",1072202,"English","# Background\n# Methods\n# Results\n# Conclusions\n# Level of Evidence","[{\"question\":\"What question does this meta-analysis address?\",\"answer\":\"It determines whether perioperative corticosteroid administration reduces postoperative dysphagia severity after anterior cervical spinal procedures and whether it causes adverse effects such as pseudarthrosis or infection.\"},{\"question\":\"How were eligible studies selected and assessed?\",\"answer\":\"The authors searched major electronic databases for randomized controlled trials and used two independent reviewers with GRADE criteria to assess eligibility, risk of bias, data extraction, and evidence quality.\"},{\"question\":\"What did the results show about dysphagia outcomes?\",\"answer\":\"Moderate-quality evidence demonstrated a significant improvement in postoperative dysphagia rates with an odds ratio of 0.35, supported by permutation and sensitivity analyses.\"},{\"question\":\"Were there differences between intravenous and local steroid administration?\",\"answer\":\"No significant difference was found between intravenous and local steroid administration (p=0.16), and there were no documented infections or a significantly increased risk of pseudarthrosis (p=0.13).\"}]","Perioperative Corticosteroids Reduce Dysphagia Severity Following Anterior Cervical Spinal Fusion - A Meta-Analysis of Randomized Controlled Trials | PDF",1792703431]